1020 SE EVERETT MALL WAY CHEVRON 2019-01-29

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwagov gov j www.everettwa.govipermits 1117Z,40004404#1440,-;,i0t1.1j. 9: 1•:: ?-;' PROJECT ADDRESS: t 02() & tr VYY?- - Ikitall tl . ) .ver.---- BUILDING AREA(if residential,new construction,remodel,or additio SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: XCOMIVIERCIAL USE OF BUILDING: OIAS ; ,•, n•gaff gte i k !! k ``tAVM CONTRACT PRICE OF WORK: t (141P NUMBER OF DEVICES(if tow voltage): FIRE ALARM? 0 YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: MOtThbtitta I t fret, t, -- OWNER NAME: i ikely i litra I TENANT NAME(If Commercial): i ,/1 '# OWNER MAILING ADDRESS: sTReET 0. .0 V I Qr�/� CITY evere STATEkA)Pt ZEP`1 U L.:L. OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Darren tp"Iter".. CONTRACTOR ADDRESS: STREET t br Aili�JIz✓/` r "'4�tf.��/p'VA 9 f 121-3 OW VeYh(W1 I STATE Y'! • ZIP CONTRACTOR PHONE:ate3) 2-1--'S2-t30 CONTRACTOR EMAIL: diet scrag, r ec-&ritJ iii. Wil. CONTRACTOR LIC.#(REQUIRED):PRI M I E S2 2,1U- CITY OF EVERETT BUSINESS LIC #(REQUIRED) PRIMARY CONTACT: vpt OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Cf 2c ) 1 _21 L j Vt A- 0/1-itli'Val I CONTACT EMAIL: ,9 `e.'V yone.USA yetivoct.e AGREEMENT'I hereby certify that l 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 lam authorized by the owner of this property to perform the work for.which application is made and I comply with the State Contractors Law i8 27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# PA\\ItV - -1 .E I - ' G Owner/Authorized Agent Signett�re Date (Revised 9/23/2016)