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(P) 425-257-8810 <br />�ECTRICAL PERMIT A�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 3O9 EqSt CqS1110 ROpd �arcel# 00598700000101 <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: l81 COMMERCIAL <br />USE OF BUILDING: <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ 500.00 <br />NUMBER OF DEVICES (if low voltage): 4 <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # if a licable : <br />DESCRIPTION OF WORK: <br />�& S Wire new lo o cabinets & channel letters to existing electrical circuits. <br />CONTACT INFORMATION <br />OWNER NAME: MOflEytfee, Ifl(. TENANT NAME (If Commercial): MOI12 tf82 <br />OWNER MAILING ADDRESS: sTReer 6720 FOrt Dent Wa Suite# 230 <br />�,n Seattle S7ATE WA Z,P 98188 <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: If1519f1IQ Sl9fl If1C. <br />CONTRACTOR ADDRESS: sTReeT PO BOX 2849 <br />�,n Renton STATE WA Z,P 98056 <br />CONTRACTOR PHONE: �425�9�%-Z�O9 CONTRACTOR EMAIL: nate@insigniasign.COm <br />CONTRACTOR LIC. #(REQUIRED): INSIGSIOSS�S CITY OF EVERETT BUSINESS LIC. #(REC2UIRED): S�o� <br />PRIMARY CONTACT: ❑ OWNER I$I CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: �4�5�9j]-2jQ9 <br />Nate Cartas @ Insignia Sign In�. coNracT Ennai�: nate@insigniasign.com <br />AGREEMENT. T 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 <br />type of work wil! be completed whether specified herein or not. The grantrng of a permrt does not presume to give authority to violate or cancel the provisions of any other state or <br />local law regulating construction or the �erformance of construction. That 1 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 />/VG.te C�c.niG� (Contractor & Agent) 08/23/16 <br />Owner/Authorized Agent Signature Date <br />City of Everett Officia! Use Only <br />FEE <br />�%�) rl.J--� <br />�V o � <br />PERMIT # <br />EI(�r�-2�� <br />(Revised 10/12/2015) <br />