229 SW EVERETT MALL WAY 2019-11-19

ELECTRICAL AL PC RMIT APPLICATION u CITY OF EVERETT PERMITVICES 3200 CEDAR STREET, EVERET , WA 98201 (P)425-257-8810 FAX 425-257-8857 j (E) everetteps@everettwa.gov j Www.everettwa.govlpermits . . ...:...:. I406k' ATIO� •- PROJECT ADDRESS: 2, 21 (,J (/crQ5& Y BUILDING AREA(if residerifial, new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: 2 T �I�1�r��'RIOAL PLIIi ATIOM CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): FIRE ALARM? 11 YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): n DESCRIPTION OF WORK: ; . CONTACTS IIatF:.,ORiVIATION" OWNER NAME: V7-4G r TENANT NAME(if Commercial): 1 OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: -OiW-NER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET 7 CITY arqz, Li'l STATE Cl) A 1 ZIP Bk 7 CONTRACTOR PHONE: ( CONTRACTOR EMAIL: fd rl 1 GG CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): d53 (� PRIMARY CONTACT:�M 0 OWNER ~CONTRACTOR 11 OTHER(Please Specify) CONTACTNAME: CONTACT PHONE: 7 �l r C1 r 15 rd CONTACT EMAIL: AGREEMENT. T hereby cerfify that 1 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 ornot 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 l am authorized by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � PERMIT# E 22J5 gvwvnedA.t' Date (Revised 1011212015)