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Cc?-7,,,, <br /> ELECTRICAL PERMIT APPLICATION /96. - r <br /> /*►1''44111 , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 q— <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: Lig I S ,LLC. it' i U.,€ ,s-t-{,,,ff,,, / <br /> BUILDING AREA(if residential,new construction,remodel,or addition)CIl1;iL�. ('It Q)'L SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING:l J h i r OpV"C,Uc+1 C. <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 5C) C) <br /> NUMBER OF DEVICES (if low voltage): 3 <br /> FIRE ALARM? ❑YES 1S NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Ir(,,,.t k 60/1.S1 cL(� ,4-c e G•,..,pL S <br /> p� ,, CONTACT`INFORMATION <br /> OWNER NAME:SUSI L SC c Iryi '1(i4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 46/1 S a(.. Creyy4VQ S-I e A <br /> CITY Ec�.i. re, STATE t�V"! zIP9 0 <br /> OWNER PHONE:g2 ��--.L.-15‘S I I` (a9 OWNER EMAIL: <br /> CONTRACTOR NAME: Alto ,S.M,(.I/ r� Lt.j Sy(r)^ .Gt1 <br /> CONTRACTOR ADDRESS: STREET iav .{�yy /(-'_ r c'T �] <br /> CITY 510 IA U! ` 1 iS A_ STATE a... ZIPCM) f e5 <br /> CONTRACTOR PHONE: t%'(Pc/1' 60-00 CONTRACTOR EMAIL: ,r)1 r) kc( r fiSo�,. J t - <br /> CONTRACTOR LIC.#(REQUIRED):/tU(J5 �9 j !p'"7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED)Ø$275 <br /> PRIMARY CONTACT: 0 OWNER '$CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1, cQ ( — <br /> f1 J itteAg CONTACTiMAIL: fU:1;(27. <br /> 4 C c-= r St„, I b <br /> AGREEM T:T hereby certify that f have read and examined this application an,know the same to be true and correct. All provisions of laws and drdinances govemin th <br /> type of w rk will be completed whether specified herein or not. The granting of a ir__loos n l sir_ .rr r_ __ •'-_, • ,,. , ---,- g o er state or <br /> local law regulating construction or the performance of construction, Thal 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 /> FEE <br /> .o <br /> .l <br /> 1PERMIT# <br /> i ibX7f(c EB \hoc -CAg <br /> wnerlAuthorized Agent Signature Dat (Revised 10/12/2015) <br />