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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: 2-( ( 5\ /,1/4 s7 i -VE <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: tikCOMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ Z-0, oC , <br /> NUMBER OF DEVICES (if low voltage): 244 <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ,Z'A 5 7-4-I,L A- C cT V s`/ S TE/—\ <br /> CONTACT INFORMATION <br /> OWNER NAME: EV F . Q EC/0 M A R TENANT NAME(If Commercial): L kiee()Q.ti E(,,r vti en) R- <br /> OWNER MAILING ADDRESS: STREET p.o . C3 0 )( (2.S cl <br /> M <br /> CITY F\/ tE- T� STATE - 'Vp l • ZIP r w 47 <br /> OWNER PHONE:4"7-c-2?o-' , 7 G1('7' OWNER EMAIL: <br /> CONTRACTOR NAME: QPrt.,I F f t✓ F I kr Sc C..4.1 '( <br /> CONTRACTOR ADDRESS: STREET 7 PO PCA-Ie P lv• S- v U <br /> CITY 5E.74"-TR-C- STATE LANA . zip ( ( <br /> CONTRACTOR PHONE:ZO(,,- )`2i- 3 S(7 CONTRACTOR EMAIL: r--a B B - --k/ Q¢1GI F(C-F-l Q <br /> CONTRACTOR LIC.#(REQUIRED):PAC] FE 511'1 fv F CITY OF EVERETT BUSINESS LIC.#(REQUI D): V 2/S4.1 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR , OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2.0 <br /> go <br /> ITE 12T \/I ( H N CONTACT EMAIL: Be '(`"v pert(r. c rase-5ecv,R(1. <br /> AGREEMENT:t hereby certify that t 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 lam authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the Stale Contractors Law 18.27 RCW and 298.200 WAC <br /> PCesRSt t zob - ?Rl -`{9 `!8 FD P/ Y1•4 <br /> City of Everett Official Use Only <br /> i <br /> PER T# <br /> e'771;11,66, E L2-09 --OZE <br /> _„).*/< /' <br /> rfAuthorized Age Sign re A pate (Revised 9/23/2016) <br />