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gn" ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ZOO 5 lilt C 114$t( C lej 410 -2 3 c_uttn—s 1446 64cI'o0 r5Ie Cr0.41 s�l-Z7 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ y00O <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES J31 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ''r'iqgtx:01.44N) (ZOV 4r+tjvv.. DtrF S:c14- 4 Ce,ci <br /> AA3c9- wtc,vc•r5 A-rV S.14-+C--(OStr(€ I 4480 V. 3 a Cv <br /> A cQ (( - K-4.44- N -ritam 4-0 r o & 34 4.DVC• <br /> CONTACT INFORMATION <br /> • <br /> OWNER NAME: /j0 f,iv 5 C.0 PA*tJ y TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Po Roc 3-7 0 7 i'M S 4 I - 0 7 <br /> CITY ,,,eP4-14-1e. STATE /t/. ZIP/8 (Zy <br /> OWNER PHONE: rr OWNER EMAIL: <br /> CONTRACTOR NAME: L I Gu'/-t`O a n�'OM- 4 t ruC p <br /> CONTRACTOR ADDRESS: STREET 411(1 3 c�,¢.Iuv..1 a4V(`i- OG 4 ejt IC. /^� aQ � <br /> CITY t/ t !4- Oa STATE �►Y ZIP L S 27S <br /> S <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: p q <br /> CONTRACTOR LIC.#(REQUIRED): E l F.GT.l 44 C 5S KA CITY OF EVERETT BUSINESS LIC.#(REQUIRED)4S f / <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) Le•ac.Q. F teal ctcI A* <br /> CONTACT NAME: CONTACT PHONE: Zt�6 - 3 S 3-4108 io <br /> JA5cr ) 5 lOv4-v\'. CONTACT EMAIL: '3'"p.SOv'u5 ., etec .t.v(,,vtio c,9L t Core) <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 /> (.02 . 50 <br /> / '/ PERMIT# <br /> /�# 7-23- � E <br /> Owner/A torized Ag•nt • pure Date (Revised 10/12/2015) <br />