3900 BROADWAY BASE FILE 2019-01-18

�' !LECTRICAL PERMIT APPLICATION �+' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJE Sr1INI ORMATiON PROJECT ADDRESS: -5q00 t` va;W? - �v� � W A .5-•z • BUILDING AREA(if residential,new construction,remodel,or addition) tS A SF BUILDING TYPE: EI SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: %COMMERCIAL USE OF BUILDING: N 0 kjvkl.Ak.n� •f .L� \ e yV--1 Cc�H..v r?b �SeC�n��r.r ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 'L 5 ,OOH NUMBER OF DEVICES(if low voltage): 4 FIRE ALARM? 0 YES NO ASSOCIATED BUILDING PERMIT#(if applicable): l'-5/4c DESCRIPTION OF WORK: \th C av'—-NeAa'a' �c S t,_�x'�\ �\A'Y^ C- GAG -rh Cry v�uw� f S'�rr cst: C st��C ems✓ CONTACT INFORMATIION OWNER NAME: .E../-e" ...111- ��b�1 G Se.,\,. 1s TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET %.(n7ca- CITY \/�2J( STATE,\\,-...11,6‘ J�/\ ZIP \ V�O OWNER PHONE: 0 (L-1-7-5) 3$5-`'N-2-C'0 OWNER EMAIL: �� 1 N t� e"'_"�\ S ••�`^J CONTRACTOR NAME: -Cs--\f. e, • CONTRACTOR ADDRESS: STREET C1 ZZ v—IDAN\�,A,.) //�� p, C� � � STATE \-4T\ ZIP 1i623 CONTRACTOR PHONE: R:.(76"`&140 22 CONTRACTOR EMAIL: - 2415 S C . C U CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5 3(0,6 3 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ,OTHER(Please Specify) 0,a•-•1\1 as..1/4,ASte: evwt; , CONTACT NAME: CONTACT PHONE: ��( - - © 6 I CONTACT EMAIL: av ( \keZ.G\ S .bt Z AGREEMENT:I 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 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# �l =- /O/� 20I, . E O ICoS Own : Agent Si •: re Date (Revised 9/23/2016)