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JUN/08/2016/WED 01 : 58 PM Greenwood Heating FAX No, 206 462 6216 P, 001/001 0 • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 4L 3200 CEDAR STREET, EVERETT, WA 93201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www•everettwa.gov/permits PRdJEdt'. IT E INFORNiAT10N.i' PROJECT ADDRESS' BUILDING AREA(if residential, new conztruetlon, remodel,or addition) SF BUILDING TYPE: SFR-DETACHED [I SFR-ATTACHED ❑DUPLEX Ll MULTI-FAMILY-#OF UNITS: 171 COMMERCIAL uSE OF BUILDING: • `` ` �LE07R,�C11,L APP�IICA,TION"iI�FORMATiQN- CONTRACX PRICE OF WORK: $ 4C)(:). W NUMBER OF DEVICES If low voltage)- FIRE olta a :FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: CONT d iN0ORMATION OWNER NAME: TENANT NAME(if Commarclal): OWNER,MAILING ADDRESS: rG j CITY STATS VIJ A ZIP OWNER PHONE: -7'-7?-- OWNER EMAIL: CONTRACTOR NAME: w Sin12T—,JUL CONTRACTOR ADDRESS; STREET 5 CITY a� Q STATE zip 13 CONTRACTOR PHONE: ZC)lo ' & CONTRACTOR EMAIL- tri "t•COVh CONTRACTOR LIC.#REQUIRED ! c (� CITY OF EVERETT BUSINESS LIC.#(REQUIRED); O(1 (A2 `�. PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:Thereby certify that 1 have read and examined this application and know the sate to be true and correct. All proV)6 o/ls oft®Ws and ordinances goveming this typ®of work will be completed whether speelfled herein or not. The granting of a pen-nit does not presume to give Authority to violate or cancel the provisions Of any other state or local law regulating convruotlon or the performance of construction. That I em author/zed by the owner of this property to pgrform the work for which apptl6iatlon is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Of Ictal use only FEE ��/•J PERMIT# to �5b EI o p, Owner]A horizetl Agont Signature Dat (Revised 1011212g 15)