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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 802, EkST'MU/6U...T ALVAy t;VEA.ETT, WA 982.0/ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) N/A SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: rOMMERCIAL <br /> USE OF BUILDING: Ar,,eE,4n0/4 ( giG) <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 4� 000 <br /> NUMBER OF DEVICES(if low voltage): A/�A <br /> FIRE ALARM? 0 YES �NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 'Z3/-50E:k15Tiwba• 130I4-ER. AMA P/eDV/DG FbWER- <br /> TO (Z) Welt/ $Olf F7'=�. <br /> .5 \-14025,0 32974 <br /> CONTACTINFORMATION.` <br /> OWNER NAME: C/T /OF EVERETT- TENANT NAME(If Commercial): Aierjr/349.K SW/A4 CEM7E1e <br /> OWNER MAILING ADDRESS: STREET 02,pp Sjbookle.. 5.772aMT if <br /> CIN EVEP.Err STATE WA zip 982 0/ <br /> OWNER PHONE: ¢25:,Z57 8800 OWNER EMAIL: CVeref pwe2 ever I+Miajoie <br /> CONTRACTOR NAME: ecgioyA,N ELEC-772/C- L.LC <br /> CONTRACTOR ADDRESS: STREET /5A35 /1(E g2AlA z7REET ,-/ <br /> CITY IQC�,2a/WCnlb `STATE WA ZIP 980.52, <br /> CONTRACTOR PHONE:42 8/4. boar) CONTRACTOR EMAIL: #S`39 L f ger a l ieSah•WWI <br /> CONTRACTOR LIC.#(REQUIRED): Se(uJDELS779 CITY OF EVERETT BUSINESS LIC.//REQUIRED): 1061 <br /> PRIMARY CONTACT: ❑OWNER frOCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: a05, fes./7/7 <br /> BEl..r da ie, P2a TMA 4I ,ONTACT EMAIL: /4 .heir illi liB{/igke- yy/ <br /> AGREEMENT:t hereby certify that 1 have read and examined this application and know the same to be true and correct. Ali provisions of laws and ordinances governing this type <br /> 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 lam 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 /> E I` O / 2 <br /> Own Authorized Agent Signature Date (Revised 9/23/2016) <br /> 'Naar eao,A/MA en <br />