10630 EVERGREEN WAY FIRST NATIONAL AUTO 2017-07-27

ELECTRICAL PERM14 keeLICATI®N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: a is v t" (-a yl uv-��4 ;'vet + wA q _O BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: OMMERCIAL USE OF BUILDING:� 4-I ELECTRICAL AIPPM(��ATIIO INFORMATION CONTRACT PRICE OF WORK: $ �G4i�, s NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES qNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: n ff CON'S AC 7 El'k]FORMATICHI O ER NAME: r ;ir5 Cdr;&r _1 Q} TENANT NAME(If Commercial): YC)Vkoj Llrld OWNE ILING ADDRESS: STREET I063ver ted L/ q CIN � tr e -�- STATE .r 1 ZIP `Q ZO 4'I OWNER PHONE: Z" 1OWNER EMAIL: K ,� CONTRACTOR NAME: — Im C V CONTRACTOR ADDRESS: STREET _tSdO a h v CITY C nw-oo lX STATE LA/ ziP '?b n O a CONTRACTOR PHONE: E I2 y — /S Z CONTRACTOR EMAIL: vV`S G MSI wCL CONTRACTOR LIC.#(REQUIRED): ENE v,M q I.;l-) CITY OF EVERETT BUSINESS LIC.#(REQUIRED):U PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR I]OTHER(Please Specify) '/\, ^ CONTACT NAME: CONTACT PHONE: ('2 5 - '�y _ 26 v�Gt►'�' e( '��' �� CONTACT EMAIL: AGREEMENT.,I hereby certify that/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 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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / PERMIT Owner/ utl prized Agent Signature Date (Revised 9/23/2016)