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LECTRICAL PERMIT AVPLICATION <br /> „to _ _ CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8890 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION': <br /> PROJECT ADDRESS: R(c.►3 9T1� PL. SE <br /> BUILDING AREA(if residential,new construction,remodel, or addition) 800 SF <br /> BUILDiNGTYPE: LSFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> .. .. . ELECTRICAL APPLICATIONINFORMATION <br /> ... . .:,: ..:: _.. .. .. .. . ,: <br /> CONTRACT PRICE OF WORK: $ booO., c� <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES iirN0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: QF.PLAc.E L,- Zoo 44t° PAWLS REQ ss RE 2 8EDRoe1/..-1 i Alt I $A'nf GO Al <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CiTY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: cogEE�Ec'ra\e. <br /> CONTRACTOR ADDRESS: STREET A , 2313 G <br /> CITY WOOD(NV(14-f STATE WA ZIP 9e 0-72_ <br /> CONTRACTOR PHONE: 2p(e'Y(i7S� 0I33 CONTRACTOR EMAIL: :0E. e cooks EL.GcnAle T <br /> CONTRACTOR LiC.#(REQUIRED): Cc gEEE Lta 4 kw. CITY OF EVERETT BUSINESS LIC.#(REQUIRED):534)t4 I <br /> PRIMARY CONTACT: D OWNER .0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Lo(e- 965%.o!31 <br /> 'Joe CONTACT EMAIL: JIVE&COr eet.E'cr NET <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 <br /> type 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! <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 00 <br /> PERMIT# <br /> ,s E4 <br /> O� er/A thorized Agent Signature Date (Revised 10/12/2015) <br /> l I 02 of- <br />