2802 BROADWAY VOLUNTEERS OF AMERICA 2017-05-15

ELECTRICAL PERMIT A, i UCATION 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. /17 PROJECT ADDRESS: �� . 12';,re�2e-k- i'. 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: $ O�Q, NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES XNO ASSOCIATED BUILDING PERMIT#(if applicable): JJ DESCRIPTION OF WORK: E nom.°- Ui cn ICA t") p CONTACT INFORMATION OWNER NAME: �1111'�,C -L TENANT NAME(If Commercial): ��C2(v �E �i h G./ /." '• OWNER MAILING ADDRESS: 2CITY q �[C G STATE CA—� ZIPL a�� OWNER PHONE: S - J r l OWNER EMAIL: F� L)e-�, i',rt 5� VGA LA.),O. =�'c CONTRACTOR NAME: -J- cc CONTRACTOR ADDRESS: STREET /J�geG L1 l L� �� A � /, CITY /'�' V 1( STATE �� ZIP `l b CONTRACTOR PHONE: 01 6-- 5 q-6 5-5e, CONTRACTOR EMAIL: dW CONTRACTOR LIC.#(REQUIRED): F L�C✓ 1� (� (�C S V CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER (CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: r CONTACT PHONE: CONTACT EMAIL: 2 ,-a,, L :�9!'�,1Iv<Qt7E��c� AGREEMENT..Thereby ertify that/have read and examined this application and know the same to be true and c ect. 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 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 I E PERMIT# Owner/Authorized Agent Signatur Date (Revised 10/12/2015)