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00101P-- 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 I(E)everetteps©everettwa.gov I www.everettwa.govipermits
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<br /> PROJECT SITE INFORMATION
<br /> PROJECT ADDRESS: ‘k\'\ 3 1.•., ';-trrT ,'''POipa.,* .\t\A,''' , C-„\„,c----_,,t,z---..V.-.17 'N \ 01 cc.;
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<br /> BUILDING AREA(if residential,new construction,remodel,or addition) INA SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL
<br /> USE OF BUILDING: Cs',SCSCkt.X., 6,:i\V‘6.) S
<br /> ELECTRICAL APPLICATION INFORMATION
<br /> CONTRACT PRICE OF WORK: $ '-' .,.; ,•,•-'
<br /> NUMBER OF DEVICES(if low voltage): 0 I 1),„ .....
<br /> FIRE ALARM? DYES 12040
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: I -1, C...,k- -\\ t A(Aiili13 A V,0 U.L SiN-C 0,....1r. CIARA:v3 I(64:
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<br /> CONTACT INFORMATION
<br /> OWNER NAME: \:::, ,,,V40,. VlAy\ CC TENANT NAME(If Commercial): C:AljtAKAk ',RI,Ct 41,, '‘',)\Q(1.\(,\
<br /> OWNER MAILING ADDRESS: veal: /3 ()(k) '",:3) G 'v, 0 ‘..(A c„,"4, sc,.._ ki, 1-c).,-
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<br /> OWNER PHONE: (..(--1..1,S.‘ 0(4 .) - 1 1.-',ru OWNER EMAIL 1\rk..-vk rt,\I
<br /> CONTRACTOR NAME: i-10-'CiAils, (-1`. ' -0,:k(A
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<br /> CONTRACTOR ADDRESS: STREET 1-k *VI- r.,)'b 4r1\ 1:-W - 31i1:- M \ ''''A -
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<br /> CONTRACTOR PRONE: Ciao\ C.\14C(' - 11Y\ CONTRACTOR EMAIL: ,, i,.S%)i•C(--‘,... \(;) (i Nr Z:Vjr1 V\14.<1.-: • (1/4,11, '\,
<br /> CONTRACTOR LIC.#(REQUIRED): ''''C>- S C\„„) C(*.e. ), ,..'.. .;-- N v., IaTY OF EVERETT BUSINESS LIC.ifiREctl RED) ) Ce4 i
<br /> PRIMARY CONTACT: DOWNER 0 CONTRACTOR rOTHER(Please Specify) :43 t\Jet‘kVl V\ '''tk'' _,/ ''.(Al'iC(1(,A
<br /> CONTACT NAME: CONTACT PHONE: ( c-;OA -1,:c1j.:1 •-- 01 k.ill,
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<br /> AGREEMENT:I hereby certify that I have read end examined this application and know the same to be true and correct Ali provisions of laws and ordinaTacei 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 CenStructien- That I am authorized by the owner of this property to perform the work kit which applicationks made and I
<br /> comply with the State Contractors Law t8.27 RCW and 296200 WAC.
<br /> City of Everett Official Use Only
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<br /> PERMIT#
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<br /> owni,h4t • ...,Agent Signature Date (Revised 9/23,2018)
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