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E�LCTRICAL PERMIT APP���ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everetfinra.gov ( www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECTADDRESS: 9O� E Mal'IIIE VI@W Df, # 207 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) N�A SF <br /> BUILDING TYPE: ❑SFR-DETACHED �SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: COI1d0 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 100 <br /> NUMBER OF DEVICES if low volta e : None <br /> FIRE ALARM? ❑YES �NO <br /> ASSOCIATED BUILDING PERMIT# if a licabie : None (Mechanical Permit# M1801-098) <br /> DESCRIPTION OF WORK: Replaced Gas Furnace "Like for Like". Disconnect existing and reconnect new furnace. <br /> CONTACT INFORMATION <br /> OWNER NAME: Kevin Lane TENANT NAME If Commercial�: <br /> OWNER MAILING ADDRESS: sTReeT 11338 33rd PL NE <br /> �,n Lake Stevens STATE WA ziP 98258 <br /> owNeR PHONe: 425-231-5452 OWNER EMAIL: BIggBUll@G111aII.00171 <br /> CONTRACTOR NAME: OIyt71pIC M@Chaf11C81, If1C. <br /> CONTRACTOR ADDRESS: srReer 21718 CGtfl AVE W, SUIt@ 207 <br /> �,n Mountlake Terrace STATE WA Z,P 98043 <br /> CONTRACTOR PHONE: 425-774-8841 (OfflCe) CONTRACTOR EMAIL: St2VB C1�OIyt11pICM2CI18flICaI.COt11 <br /> CONTRACTOR LIC.#(REQUIRED): ��L,�-fN���� r'�"`L��__��� tTY OF EVERETT BUSINESS LIC.#(REQuiRED): 019260 <br /> PRIMARY CONTACT: ❑OWNER 1�1 C NTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-344-9140 (C@II) <br /> Steve Elder coNTacT ennai�:Steve@OlympicMechanical.com <br /> AGREEMENT:I hereby certify that!have read and examined this applicatron and know the same to be true and correct. All provisions of/aws 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 consfruction or the pe�formance of construction. That I am authorized by the owner of this property to peAorm the work for which application is made and! <br /> comply with the State Contractors Law f8.27 RCW and 296.200 WAC. <br /> Olympic Mechanical, Inc. State L&I Electrical Lic. ; EC OLYMPMI002DG <br /> City of Everett Officia!Use Only <br /> /,V�"`f PERMIT# <br /> �i� /' � / �C�/� <br /> - . � E ��►�l -- �2 Z <br /> r <br /> `�wner/Autho ed Agent Signature Date (Revised 9/23/2016) <br />