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Asof ELECTRICAL PERMIT APPLICATION <br /> ,;.., CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 132.1 (Lc (by E E2J'e;(e_4I 5-762:6 <br /> I <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: f 1 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ ,q Z5", 351. GG <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: V-e_Pae-C- i v SCA) bcr( i ✓' 11 r-(,3 j v, <br /> per (awl rcui ewecf 5 <br /> CONTACT INFORMATION <br /> OWNER NAME: Fr-00--,46,,(6 /-e.5/a.1a 1 /1.4CQic4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: V 4 5[P('4,-(i`;C_ <br /> CONTRACTOR ADDRESS: STREET ,, I'-1 S ?O BoK <br /> ,,/b)gep /� <br /> CITY STATE ��-t ZIP I83 48 <br /> CONTRACTOR PHONE: zw.,.-43C, 3) CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): t/e...A (-) CITY OF EVERETTBUSINESS LIC.#(REQUIRED): 4T43 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE: 2.,D(6.,-a5b 3(6 <br /> CONTACT EMAIL: aso/1, .S � `tr.Jct(df <br /> C�Vz C <br /> AGREEMENT.I hereby 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 <br /> of work will 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E no.-1-0(, ) <br /> Owner/ thorized gent Signature D e (Revised 9/23/2016) <br />