4835 EVERGREEN WAY ACE HARDWARE 2016-08-04

•LECTRICAL PERMIT ASLICATION d CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: r-tiE 'i G"j,,.1?�C /'( F I �{ 2c �/ (�<'/ e-11-. BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED f 0 SFR-ATTACHED ❑/DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: d-]C;•� -Y(CI•GL,I;i`(` ' '�G(r (z`' ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ;-V)r:J C) NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES kJ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 12 G'�( ,o/l�_ �l t L)r'S %(�l Gt! '.r wi J- L`� I.J el' s S -1 s r c<(.0 ! "r-c.( G, s .4,71-6 CONTACT INFORMATION OWNER NAME: I C't f-/p 7 /ie (�(�/IG/`r� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET r� 3 Cj5' J (�i•-t//�;�i(p-Of I (,Oc / ( 7 CITY IV P' / STATE L0 1� ZIP C? 49(/3 OWNER PHONE: 1-/0-3– ( '(Q G f/f a- OWNER EMAIL: Tei T-77--/ Evef yr- 0A ta—z y CONTRACTOR NAME: J(,r,)/'j,�G— (/ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT, WO NAME: /} CONTACT PHONE: G/� C� 144 a. ° G( L I CONTACT EMAIL: Tru /t /vI (l��/ `/ /T 0,1a�%v7GY'vCv1 T AGREEMENT:Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The grunting 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 I am authorized by the owner of this properly to perforin the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of£_verell Official Use Only FEE .r /j/ PERMIT#L201 - 1 )-1:-) e) E Owner/Authorized Agent Sig tune Date � (Revised 10/12/2015)