3632 BROADWAY VERIZON 2019-07-09

/OW, LECT ICAL PERMIT A413LICATION CITY OF EVERETT PERMIT SERVICES viti 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 36 3 2 Q,r-o a et c4) BUILDING AREA(if residential,new construction,remodel,or addition) SF • BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: AOMMERCIAL USE OF BUILDING: Rt'_.'t-A,Z ELECTRICAL APPLICATION INFORMATION 4.7 CONTRACT PRICE OF WORK:$ (k O 0 L NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES LNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: RR move art Peel QVie, expsINA 5 c,rc,v \A/Le pee new apeh,4 Ih wwII oGcc'rc .z, CONTACT INFORMATION - _ OWNER NAME: Vac, wr TENANT NAME(If Commercial): 5-7-404 r/m o e.J e,..T OWNER MAILING ADDRESS: STREET crrY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 12.£ S" Ere c/ 1` - CONTRACTOR ADDRESS: STREET 18 g L O / // A.in' ,G"o( 5-re D CITY /// /? (.� STATE 44"4L) pJ ZIP I p 2-2-3 CONTRACTOR PHONE: 3 6 0-6 FT-, 5"I CONTRACTOR EMAIL: /(1i sitA S C(eCOr S eiec 1�t• o CONTRACTOR LIC;#(REQUIRED): R FLG C3 22 Gt Z CITY OF EVERETT BUSINESS LIC.#(REQU1- D)D t—tr-A S PRIMARY CONTACT: ❑OWNER .CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: C 2 C- 2419-Vol 3 / ©ac., V( /,y` G1L(o CONTACT EMAIL:W d f es„, 1"0 c2 �' SP I�GJ�t G f0 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 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 tam 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 FEE R2Q PERMIT* ..1 ,3h3 E � go� ao2 — Owner/A ••rized A nt Signatu Date (Revised 10/12/2015)