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03102/2016 14: 43 20629115�0 PAGE 01/01
<br /> EL�CTRICAL PERMIT APPLtCATION
<br /> ClTY OF EVERETT PERMIT SERUICES
<br /> 3200 CEDAR STREET, EV�RETT, WA 98201
<br /> (P) 425-257-8810 � FAX Q25-2b7-8857 � (E)everetteps@everettwa,go�� www.everettwa.govlpermits
<br /> . ;. ; .PRQJ�CT $1"�E 1N.�dRMAT1aN ,� ',
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<br /> PROJ�CTADDRESS:. , SO�IO V�EW DR_. ., . , : , ; .,.
<br /> BUt�d1NG ARER if reSldenfial, rlew construetlon, remodel:or aciditlonj 5F �
<br /> ' RUlLDING 7YpE:.C)SFR=D�TACHED.:O`SFR-ATTACHED ❑ DUPL�Xr �MULI'I-FAMILY-#OF:UNITS:. CONIMERCIA�.
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<br /> iJSE o�BUILDING: ;:, ;
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<br /> � ELEGTRtC/l�:�AP,PLI'��vT10N INFQRNIA'i'ION •;: �
<br /> RAC , `
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<br /> , ' CONT 7 PRICE OF WOaK: $ , 4540�00 ,
<br /> NUMBER OF DEVICES. if(ow volta e : .. 7 .
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<br /> FIRE�1LARM? YES ❑.No
<br /> ASSOCIA�ED aU1L�ING..p�RMIT# if a licable �
<br /> �EscRiPTION.oFwoRK: Add 7 devices ta-new ortabl� classi,onm Por#�ble 5 for Lowell Elementa .
<br /> Will ti in to existin fire alarm s stem. �
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<br /> , ...: r, w,.i� �` ° �, \ .''. ,',,�� � �',g�. �'�I�,i�d�,�j�1r������.Q�! �.',�� r'�7ye� � 7 ��'.�"� '�� ;;r `Ct� ��..�.. .
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<br /> I TENAN7 , ' .,�;
<br /> OWNER NAME . , .
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<br /> • NAM� If Ccsmmerciel)::
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<br /> oWNER MAI�ING ADDRESS: stREer 1 �1.7 I� P •
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<br /> ' � ��� Everett sTA� WA z�P 98203
<br /> OWNER PHONE: 2O -436- 57' OWryER EiNAIL� .
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<br /> CON7RACTOR NAME� SIfT']p�@�(Gf111f1E.'��
<br /> CONTRAC'rOR ADAR�SS: �eEr J �Qth Ye S. it8 1
<br /> � �� Seattle � �n� WA Z�P 98�08
<br /> CONTRACTOR PHONE: 2Q6_29�-� OO CON`fRACTOR EMAIL� �a tebbins sim lex rinnelt com
<br /> C�NTRACTOR LIC.fi(REQiJtRED� �M�7 *�g� CITY OF EVER�TT Bl1SIN�SS LIC.#REQUIRED : 6OZ 3l�
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<br /> pRIMARY CONTAC'f: ❑OWNER �CONTRACTOI� �OTH�R(Please Specify) .
<br /> CONTACT.NAME: Co1�TAC7PHONE: � 2a�_29�_14.68
<br /> Janet Stebbirrs cot�T,acr E�,��:.
<br /> AGRE�M�NT.�T heieAy eer�ily that!have read and ezeminetl tMis app��tlar and know i/te same to be true and correct A�l provlslons oflaws anu ordinances povaming(g!s
<br /> rype ot wor�k will be completed tiyhetAer spaciJ/�h y$in or�oL The giani(ng of a perntf�Qoes not pre�me lo give�utAwlky to violyte or Cancel�e/�roYisior�a o1 sny other ats�pr
<br /> /oCa/Jaw�egulafing cong)ruction orlhe porfomlance ot consfiroUpn. Tnat I�tm sutllorized by ihe ewner aT thls pnmpe�t}+tp�prm tlje�vpry�fa�vhjch app/�calion ig maae�nd I
<br /> corn,ely wifh tRe State Cpntractara Lew 78 27 RCW antl 298.200 Wq�
<br /> �/_ �7 / p. �ty vf�Lerett Offlcial Use Only
<br /> ct��� C�II �O�C -o.��/- I�(o d GL�[d � Wt��I �p✓D�ITc�P �EE
<br /> V IS/�- �`- 7�- �7R�v�en�• 77-r��� �'f � � ��'- l �-�
<br /> PERMIT#
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<br /> � ne t ed Agent 81g ture Date
<br /> (Revised f0/92/2016)
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