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EtkCTRICAL PERMIT APIOICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3327 Paine Ave Everett, Wa 98201 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: © COMMERCIAL <br /> USE OF BUILDING: Temp Office <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 150.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑ YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Install Temporary Power pole <br /> CONTACT INFORMATION <br /> OWNER NAME:Skotdal TENANT NAME(If Commercial): Strom Holding <br /> OWNER MAILING ADDRESS: STREET 2707 Colby Ave #1200 <br /> ,IT, Everett STATE Wa Z,P 98201 <br /> OWNER PHONE: 4252525400 OWNER EMAIL: <br /> CONTRACTOR NAME: Strom Holdings <br /> CONTRACTOR ADDRESS: ITREIT3335 Paine Ave n <br /> CITY Everett STATE Wa ZIP L <br /> CONTRACTOR PHONE: 4252448277 CONTRACTOR EMAIL: nmlkec@stromholdingS.Com <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(R IRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42.552448277 <br /> Mike Calabro CONTACT EMAIL:mikeC@StromholdingS.COm <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 <br /> local law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 PCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> EVo� - 220 <br /> Owner/Authorized Ag n7gnature Date (Revised 9/23/2016) <br />