7207 EVERGREEN WAY IGLESIA CRISTIANA PALABRA DE AMOR 2019-01-11

ELECTRICAL PERMIT APPLICATION CITY OF' EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everetfinra.gov/permits t , . � . , : -_- ' . PROJECT SITE INFORMATION .' , PROJECT ADDRESS: — � , BUILDING AREA(if residential, new construction, r odel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: \ ,,. � ;; ` ' ELECTRICAL APPLICATION INFORNIATION ' CONTRACT PRICE�OF WORK:$�� . � �,�,� � �� !�' � � ��'� ��. ,, __�, _ �, ./ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -� � � -� S _ � �-� � S `e , _ - CONTACT INFORMATION ' . OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rReer CITY � STATE ZIP . OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: C I� CONTRACTOR AD RESS: STREET � 2j� ` � 1 0 l �� CITY STATE ZIP CONTRACTOR PHONE: � Z CONTRACTOR EMAIL: Gtvt rJ 51'�U'P7 It°C'FItC�tf�''� CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.�T hereby certify that l have read and examined this application and know the same to be true a�d correct. Al1 provisions of/aws and ordinances goveming this fype of work will be completed whether specifred herein or nof. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which appficafion is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WqC. City of Everett Official Use Only FEE � (�220� PERMIT# � QV� • �`� � E i l� ��1' D� Owner/Authorized a ure Date (Revised 90/1?J2015)