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(449.7 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 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> . . . : :' : • E I MAT ON <br /> . .:• .."O:1 �Cc� SIT NFO <br /> PROJECT ADDRESS: 3ea3 WEST 0,-.40.5040 ROAD e V vLat WA `82.• ' Ao .a ° . '.' <br /> BUILDING AREA(if residential,new construction,remodel,or addition) M/A. SF ,,/ <br /> BUILDING TYPE: D SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1. uOMMERCIAL <br /> USE OF BUILDING: Ma1-4UFAC TUV-It4G-t <br /> ELECTRICAL APPL1CAITION::INFORMAtION . ` . <br /> CONTRACT PRICE OF WORK 3$24 P <br /> NUMBER OF DEVICES(if low voltage): N/A <br /> FIRE ALARM? 0 YES frieNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): N/A <br /> DESCRIPTION OF WORK: TEMpott4 Llo•X)S:Mil -T1O1J power./ iBr¢,A•ALCI1 W2 )tr MObtF1CAT10t1/44 <br /> r±.IGaritJ6(IvE Foal-O7'J )Rt?PL_A•C6MeNr/, 'F02815,14M <br /> DIYICe(oAIE—FM-0140 R2EPt-AaeMEALT '# /A1 7AW GFc/ 1312EAKWAS <br /> el" - 32431, <br /> • ..: . .. .. . ::001,1-:`A0t: NFORMATION :.. . ':i'::::,-.:'":::::::,:':: ,.:*:: . ._ <br /> OWNER NAME: .6b 7A . TENANT NAME(If Commercial): t3Dre1/4140 <br /> gi <br /> OWNER MAILING ADDRESS: STREET IPO 6oJC 3707 p ' ^ <br /> crw Ve-leSTATE W�4 ZIP 98/24"A '�/.y <br /> OWNER PHONE:...3/2.51f.Zero° _OWNER EMAIL: #4/A <br /> CONTRACTOR NAME: „sequoyA-{t eye-r_ c LLc <br /> CONTRACTOR ADDRESS: STREET 15/35 Ne 9zit/b �rZ,EET <br /> cm, gal/4 1411 STATE WA ZIP 9fj 66.2. <br /> CONTRACTOR PHONE: ¢2.5. 6/4. b ocO CONTRACTOR EMAIL: g )1ry.belc1119er 0 sec1uietlr- <br /> CONTRACTOR LIC.#(REQUIRED): SE'QVOEL 977 CITY OP EVERETT BUSINESS LIC.#(REQUIRED): '� 445 <br /> PRIMARY CONTACT: 0 OWNER t.j2rCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: .4z5.225i.2515 <br /> JIM At tbt gSor t., G ewsposL Fole.EMAM CONTACT EMAIL: 3i rn•q hdcrso n C sect l,.to`t�bLVi• Lcwt, <br /> AGREEMENT:I hereby certify that I have read and examined this application and know Me same to be true and correct. All provisions of lawsandordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a penmit does not presume to give authority to violate or cancel the provisions of any other slate 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 /> PERMIT# <br /> GARY AB t3.22.J8 E \V %- t (/+ <br /> ER <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />