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Jul . 28. 2014 10 :27 PM Community Electric LLC 3606548987 PAGE. 1/ 1 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-267-8810 1 FAX 425-2578857 ( (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: IL BUILDING AREA(if residential, new construction, remodel, or addition) SF �Z O C)0 BUILDING TYP • R-DETACHED ❑ SFR-ATTACHED CIDUPLEX ❑ MULTI-FAMILY-40F UNITS; b COMMERCIAL USE OF BUILDING: 19LECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ z(j 00C NUMBER OF DEVICES if low voltage), ---, FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: .S�'i'� CONTACT INFORMATION OWNER NAME: f- 6 L UV) TENANT NAME If Commerclal : OWNER MAILING ADDRESS: STReeT CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STRF.F..T CITYSTATE ZIP CONTRACTOR PHONE: 3 iC1ONTRACTOR EMAIL-. M YA 1 C I CONTRACTOR LIC.#(REQUIRED): C om M e �i CITY OF EVERETT BUS SS LIC.#(RFgUIRP-0): PRIMARY CONTACT: ❑ OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAMES CONTACT PHONE: `3� U a Dls t ! Lt^ CONTACT EMAIL: A OREEM€NT:T hereby certify that 1 have need and examined this application and know the same to be true end correct- All provisions of laws and ordtnancas governing this type of work wiN be completed whether specified herein or hot, Tho grahting of&permit does not presume to give authority to violate or cancel the provls/ons of any other state or local law regulating construction or the performance of constn,ction. That t am authorized by the owner of this property to perform the work for which application Is made and I comply with the State Contractors Low /►18..27,,RCW and 296.200 WAC. C V `U-ko� � ] b Q' -e, f V- City of Everett Offtclal Use Only T(? (�,L +� `� � FEI= PERMIT# E ✓ ownerl horized Agent Signature tate (Revised 10/121201 B)