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� <br />� <br />� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: Z�JOrJ PaCIfIC AV@ EV@I"@tt, 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: 0 COMMERCIAL <br />USE OF BUILDING: Retall <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ 2500.00 <br />NUMBER OF DEVICES (if low volta e: _ <br />FIRE ALARM? ❑ YES 0 NO <br />ASSOCIATED BUILDING PERMIT # if applicable : <br />�EscRiPTioN oF woRtc: Replacing bad lamps and ballast thraughout store as needed. <br />CONTACT INFORMATION <br />OWNER NAME: LOW@ COf71p81112S TENANT NAME (if Commercial): ____ <br />OWNER MAILING ADDRESS: sTReeT 1605 Curtis Bridge Rd <br />�R„ Wilkesboro ST„TE NC „� 28697 <br />owNeR PHONe: 1-800-445-6937 OWNER EMAIL: <br />CONTRACTOR NAME: WeSt COaSt Llgiltlilg Sc E11@fgy, INC <br />CON7RACTOR ADDRESS: srkeeT 18550 M inthorn St <br />�R., Lake Elsinore STATF CA „P 92530 <br />CONTRACTOR PHONE: 9�J�-Z96-O6HO CONTRACTOR EMAIL• kfay@WeStCOaStIlgYltlilgalld2ll@f . f71 <br />CONTRACTOR LIC. #(REQUIREDI. — ITY OF EVERETT BUSINESS LIC. #(REQ Eo>: 047162 <br />PRIMARY CON7ACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) _ <br />CONTACT NAME: CONTACT PHONE: 95�-296-�6$0 <br />Karen J. Fay coNracr EM�v�:Same as above <br />AGREEMENT: I hereby certify [hat ! have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governrrq this type <br />of work will be completed whether specified herein or noL 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 1 am authoiized by the owner o( this property to perform the work for which application is made and I <br />comply wiih tlie State Contractors Law 18.27 RCW and 296.200 WAC. <br />� City of Everett O(fir.ial Use Or,ly <br />PERMIT # <br />E l�C C -- l <br />(Revised J/23/2016) <br />