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OLT 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 1 (E) everetteps@everettwa.gov l www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 727 35th St, Everett, WA 98105 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) Kitchen Remodel 500 SF <br /> BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: Residential Single Family <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ Approximately $4,000 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES m NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: 1)Total Rewire of Kitchen circuits, Install New Appliances, Replace all existing kitchen 120v outlets(4 outlets), <br /> Replace light switches (3 switches), add 3 additional 120v outlets. Appliances include refrigerator, oven, cooktop, dishwasher, <br /> microwave, garbage disposal. 2) Full replacement of main electrical panel. 3) Replace and upgrade electrical meter. <br /> CONTACT INFORMATION <br /> OWNER NAME: Matthew Moe TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 727 35th st <br /> CITY Everett STATE WA ZIP 98105 <br /> OWNER PHONE: 425-773-4477 OWNER EMAIL: moem@uci.edu <br /> CONTRACTOR NAME: Jake Pahlman <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP � \ <br /> CONTRACTOR PHONE: 206 250-3990 CONTRACTOR EMAIL: \\\ <br /> CONTRACTOR LIC.#(REQUIRED): PAHLMEIO9OK1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 049670 <br /> PRIMARY CONTACT: VI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <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 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 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 /> PERMIT# <br /> /I tr-t- � E <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />