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E CTRICAL PERMIT API CATION <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 /> PRo�ECT aooREss: 1130 W Marine View Drive <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: � COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 100.00 <br /> NUMBER OF DEVICES (if low voltage): � <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF W�RK: Install 1 lit wall sign <br /> CONTACT INFORMATION <br /> OWNER NAME: NBtlOf181 OIIW@II V8CC0 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEr 1130 W Marine View Drive <br /> �,r,. Everett sTarE W/4 ziP 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Be��/ SIgC1 $ySt@I71S <br /> CONTRACTOR ADDRESS: sTReer 7400 Hardeson Rd <br /> �,n Everett STATE WA Z,P 98203 <br /> CONTRACTOR PHONE: 425.776.8835 CONTRACTOR EMAIL: t�BCI@S@b@ff')/S19C1SySt@fY1S.COfT1 <br /> CONTRACTOR LIC.#(REQUIRED): berrYSS853W7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 247H6 <br /> PRIMARY CONTACT: ❑OWNER QJ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.5835 X 'I'I4 <br /> Tracie Skiles coNracT EMai�: tracies@berrysignsystems.com <br /> AGREEMENT:I hereby certity that 1 have read and examined fhis application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work wifl be completed whether specified herein or not. The granting of a permit does not presume to give authority to vio/ate or cancel the provisions of any other state or <br /> local law regulating construction or the pertormance of construction. That!am auihorized by the owner of this property to perform ihe work far which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Eveiett Official Use Only <br /> PERMIT# <br /> E r���� f � �� f�� <br /> OwnerlAuthorized Agent Signature Date (Revised 9/23/2016) <br />