505 SE EVERETT MALL WAY SPRINT 2017-04-28

LECTRICAL PERMIT A� =QCATION 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� .. � ( C.A 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:$ 00 NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES i7 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION:OF WORK: 7, h CONTACT INFORMATION OWNER NAME: � TENANT NAME(If Commercial): OWNER MAILING AD RESS: STREET 'U Q V l cQ CnY STATE ZIP • OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: s P My l Y��'`�� STATE ZIP J IIV CONTRACTOR PHONE: tS� CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): S �S LN� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Z PRIMARY CONTACT: ❑OWNERCONTRACTOR ElOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LTZ-S-2 2( P VA +� CONTACT EMAIL: S }( .; AGREEMENT Thereby certify that I have road and examined this application and know the same to be true and correct All provisions of la orA nces erning this type 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 local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# E 2- 10 O r uth ' ed Agent Signature Date (Revised 10/1212095)