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46-77". 1= CTRICAL PERMIT APS—CATION <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: 1330 Rock ( (,tr tt�4 .2evcr-L`-t- 0214 IN1,3 2o <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: I g` C C <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1600.t"2- <br /> NUMBER <br /> tOV.` 2NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> • <br /> DESCRIPTION OF WORK: At(4) e- 4- 5-:,41 i'•'L Scar ie._ PIC <br /> tt) C 15'f1 �t (f t 's rtr�u;f <br /> CONTACT INFORMATION <br /> OWNER NAME: ?re, (t ( 'L<jc N& WeAjce.,( TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY <br /> STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: VECA E(qtr,L <br /> CONTRACTOR ADDRESS: STREET '?o .ox- 00440 <br /> CITY (� STATE (1)4 ZIP (d b <br /> CONTRACTOR PHONE: 2Gto`4/ •52-00 CONTRACTOR EMAIL: <br /> • <br /> CONTRACTOR LIC.#(REQUIRED) E-CA ECT-5 ,CITY OF EVERETT BUSINESS LIC.#(REQUIRED):00494 S- <br /> PRIMARY CONTACT: 0 OWNER <br /> [CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2.042- <br /> ='k+ ScLejukkcta CONTACT EMAIL: cc,ek ; �?cf� e <br /> AGREEMENT:T 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 <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 /> PEfTz <br /> IT# <br /> 12. /6 - 1�2 <br /> 0 er/Authoriz Agent Signature D (Revised 10/12/2015) <br />