2730 OAKES AVE FOUNDATION CHURCH 2016-08-25

�.ECTRICAL PERMIi AF�L.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 SITE INFORMATION PROJECT ADDRESS: 2�3 � (/.QQ� BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-# OF UNITS: COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ O�, QO NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRiPTION OF WORK: %I ��' � �►� C�w� ,�o� � CONTACT INFORMATION OWNER NAME: Y �✓'P� TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srReET '% C� � G'V'� CITY �� STATE �� ZIP / C> �/ OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: C � � �C CONTRACTOR ADDRESS: sTReeT / �( �S�/ '/ S� � CITY ��` STATE w� ZIP ��{�(!. CONTRACTOR PHONE: ��lp�- G�S�2 CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): S S _ __ _ _ _ _ _ . _ _ _ _ _ __ PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE; CONTACT EMAIL: AGREEMENT. T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of /aws and ordinances goveming this type of work will be completed whether specified herern or not. The granting of a permif does not presume to give authonty to violate or cance/ the provisions of any other state or local law regulating construction or fhe perfo�mance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comp/y with fhe State Contractors Law 98.27 RCW and 296.200 WAC. Owner/Authorized Agent Signature Date City of Everett Otficia! Use Only FEE �� PERMIT # E i��- �,g� (Revised 10/12/2015)