221 SE EVERETT MALL WAY SIGNARAMA 2017-12-14

CTRICAL PERMIT API.ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 ( (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT 517E 1�NFORMA'TIN PROJECT ADDRESS: 0,I Oita BUILDING AREA(if residential,new construction,remodel,or addition) J�• (o SF BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX 0 MULTI-FAMILY-#OF UNITS: I rCOMMERCIAL USE OF BUILDING: Y�E ELECTRICAL APPLICATION.INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES I'NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: CONTA4T INFORMATION OWNER NAME: V( t TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ✓1l CIN S n v t ✓n0"_ STATE w pr T ZIP �V a OWNER PHONE:U JOWNER EMAIL: CONTRACTOR NAMES CONTRACTOR ADDRESS: STREET a Crit QrZft STATE ZIP CONTRACTOR PHONE:4�'�-S 8 CONTRACTOR EMAIL:_�-)RO A U)e I (-Ovv-,, CONTRACTOR LIC.#(REQUIRED): Q IA Co CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR CK OTHER(Please Specify) w CONTACT NAME: CONTACT PHONE: L4 ag_ 3� L4 CONTACT EMAIL: AGREEME T:T hereby certify that I have read and examined this application and know the same to be t and correct. All provisions of laws and ordinances goveming this type of work I be completed whether specified herein or not, The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett OBrcial Use Only FEE el S S� PERMIT# E IGoa - IS Owner/Authorized A t Signature Date (Revised 10/12/2015)