1402 SE EVERETT MALL WAY FOOTLOCKER 2017-04-28

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits j i PROJECT SITE INFORMATION PROJECT ADDRESS: �Q �, W V BUILDING AREA(if residential,new construction,remodel,or addition) _SF 1 BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: y) Ma`1 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: ()(Doo0 NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES ❑NO I — ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: V mit �Qh'1pf C1C� rf I �QS- 1( q SGS e C 9 1 i pi f CONTACT INFORMATION OWNER NAME: ve T_t ` TENANT NAME(If Commercial): r � E OWNER MAILING ADDRESS: STREET CITU STATE ZIP o OWNER PHONE: z{25 — 1-1-11 OWNER EMAIL: N In CONTRACTOR NAME: `� } CONTRACTOR ADDRESS: STREETE�InL� e STTE -SCI— ` STATECf� LP`t 2tfl CONTRACTOR PHONE: cel T CON�T7G�RACTOR EMAIL: Ir\ 5 com CONTRACTOR LIC.#(REQUIRED): S zS K CITY OF EVERETT BUSINESS LIC.#(REQUIRED) S I I S9 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) LIZ CONTACT NAME: 'n CONTACT PHONE: Ct�1 ZQ.y, L 17- UY , CONTACT EMAIL: 'Z, \0. ,vY� r• �J� �S �Q AGREEMENT:T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing 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 or any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/Autho ed Agent Signatu Date (Revised 10/1 075)