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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 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Z.92.o Tim lIMAL.AVVt tU5 EVEtz-ETT, WA 98201 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 14/A SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: erCiMMERCIAL <br /> USE OF BUILDING: 140•12-IIIA <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 11 2,90 <br /> NUMBER OF DEVICES(if low voltage): IVA. <br /> FIRE ALARM? 0 YESNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Rs Move # R L-A-CE -119-At�lsFo>e4ME12EaISdoMtJEc .EX.ISTI NIG <br /> PA'-Mam..rr b MV`t-e-ct4S -P-4 R-EPL.ACE w/NiEW (F0.3 <br /> 5ez. 3z442. <br /> CONTACT INFORMATION <br /> OWNER NAME: 'Pop:-r' of YEr-6 -r r1� TENANT NAME(If Commercial): To <br /> _1'SO)Ce—c oc Ev p- r-r <br /> OWNER MAILING ADDRESS: STREET RO. . 53$ _ _ _ <br /> crrY EVEYL.e-r'r STATE WA zip et 820 6, <br /> OWNER PHONE: 425.Z59.3164- OWNER EMAIL: ,o)en @ port-u�OVere. }'. Conn <br /> CONTRACTOR NAME: 6EQUOY,tc E�.>✓CT12 tG L-I-C <br /> CONTRACTOR ADDRESS: STREET I SM5 'Ne c(ZIsAto 6"r12lEET <br /> CITY Mb1.4o ,D STATE <br /> I1 WA ZIP 9 052. <br /> CONTRACTOR PHONE: 4Z5.St 4. to,OC ) CONTRACTOR EMAIL:Baru. .�jGlarZgert&.SBC No1.tGtk•Ca'rv1 <br /> CONTRACTOR LIC.#(REQUIRED):6Eclit.)0 1.-9'-1<-7Sg CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 4o( 45 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42,5.905. 1111 <br /> "e,BELAiV ,Beale-6T MAIAA4CONTACT EMAIL: c6o‘rc�. ower@ 524:wert oil.Co7vl <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and corract. All 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 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 /> PERMIT# <br /> /o44.2.. /2 E IZVD - 1(oc( <br /> Ow r/Authorized Agent Signature Date (Revised 9/23/2016) <br /> PRO.IEc.T!! ee-b1/4./st'jag <br />