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_ECTRICAL PERMIT A_R_ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 15,)3 (3NQ5 i 6E,sinif q`64 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) aO D SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: '',gOOMMERCIAL <br /> USE OF BUILDING: by,,A, <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1500,0I0 <br /> NUMBER OF DEVICES (if low voltage): a <br /> FIRE ALARM? ° YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ADUSn/6 . Vs5v4-L. 1)LvsciGs TO 145 NEIn! IWU flooe,s oAi 1 iE EXsfs;Nb <br /> FsP-E ALAI" sysTEr. . <br /> CONTACT INFORMATION <br /> OWNER NAME: °Li p t. bbLow 4 NoIL9i.4 L.L.0 TENANT NAME(If Commercial): ANy1SME FSTNESS <br /> OWNER MAILING ADDRESS: STREET ,p, t7it qct <br /> CITY STATE Wk ZIP 4160IS. <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Wt.sta.g SiteiES FSAE ?&olrclio/'/ <br /> CONTRACTOR ADDRESS: STREET I111,9 p /.1 f g 1 ti ST 44-1o) <br /> CITY Ktt fr O 4 STATE Wit ZIP -1 gOS A� <br /> CONTRACTOR PHONE: 1-0-5-4146 CONTRACTOR EMAIL: Stfili,ttIin►pEk @J W5f9,U5 <br /> CONTRACTOR LIC.#(REQUIRED): 14,/E51};.3 Flo bP l CITY OF EVERETT BUSINESS LIC.#(REQUIRED): d an553 <br /> PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1-1)F- q 3o`t <br /> 501-‘\ CONTACT EMAIL: 6EtH If.)4A/(rtn. p t15fQrv5 <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> 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 <br /> 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> *01 t <br /> PERMIT# <br /> k a - ( 1- tk Els (401 <br /> Owner/ thorized Agent Signature Date (Revised 10/12/2015) <br />