11419 19TH AVE SE NOODLE BAR 2017-09-25

/I law ELECTRICAL PERMIT fiGPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I A 1 r U/0-- IV2Q BUILDING AREA(if residential, new construction, remodel, or addition) I•^ SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: N�COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ �— NUMBER OF DEVICES (if low voltage): AJS FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: l CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): A/610.0 ter Alw_ OWNER MAILING ADDRESS: STREET t-\ k(,ff CITY v�G v`'9 1 STATE ZIP OWNER PHONE: • 2?—��. OWNER EMAIL: V-2AK . Q 8 �I CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE zip e V [- Od CONTRACTOR PHONE: �_ �d� 0(fCONTRACTOR EMAIL: I'e— G CONTRACTOR LIC,#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 7�a ,O(�2 X l V_ C_Vl1_*6_ CONTACT EMAIL: C,p (( O AGREEMENT.'T hereby certify that I have read and examined this application and know the same to be true and correct. Al/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 I 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 FEE PERMIT# 2 Ovvne uthorized Agent Sign re Date (Revised 10/12/2015)