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2LECT ICAL PERMIT AICATIO <br /> moigi CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-88571 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT.SITE INFORMATION <br /> PROJECT ADDRESS Wan C(V JVI\ 303 VN `vU Ino R I t V� i WP ` "t W)2O� <br /> BUILDINGi'.AREA(if residential,new construction,remodel,or addition) SF t1U-7 ,,\O O '' 61. U \."(' <br /> 1 <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 'COMMERCIAL <br /> USE OF BUILDING: <br /> _ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ q 000. Go <br /> NUMBER OF DEVICES(if low voltage):, 3 <br /> FIRE ALARM? ID YES S`J NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Ke\UC( -e Q0 am? G\d OW1 j2 \.Y O V d)S C(fv QC1 . <br /> Fos\bon u ANd <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: woon er aiN ) BYC \ u <br /> !k t <br /> CONTRACTOR ADDRESS: STREET yQ4X )Y2QW <br /> CITY (e <br /> STATE ` IR <br /> ZIP gp17 0c, <br /> CONTRACTOR PHONE: Z.OGl l N 9,3272'/ CONTRACTOR EMAIL: yad111ge y f.ryi sir!. Q U►v ). ii . <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED):M i Li,,//v <br /> - <br /> PRIMARY CONTACT: WNER I2ONTRACTOR 0 OTHER(Please Specify) <br /> r. <br /> CONTACT NAME: CONTACT PHONE: <br /> brads. CONTACT EMAIL: <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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> W \t)2, <br /> p P PERMIT# <br /> r AA,; ,, ')L,, <br /> E 1 ?),05‘-2()L1 <br /> Ownar/Authorized Agent Si ture Date (Revised 10/12/2015) <br />