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i <br /> lifiliPiELECTRICAL 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.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: St t Z9c ILF L`t LkY/ 4-1,15- <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: tF1COMMERCIAL <br /> USE OF BUILDING: ('3;'"'ICeS <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 800 V L° <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION1OF WORK: --)156oti,o&7a-r- A-?,0 -c,L ) ..- - ,ULA) Kir r9 f,t_- <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): 6so,J0 4„„..„,„ <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> Co..rrafte.TIw LCC <br /> CONTRACTOR NAME: lZ�1veski FibE��1,,.�(,,, nn Cr <br /> Ahs I 'te/ �`,e.vt,,�,� K4• l <br /> CONTRACTOR ADDRESS: STREET a2 a <br /> CITY -r_e' )44,4Ek,S STATE 1AJA, ZIP ' 2f8 <br /> CONTRACTOR PHONE: 'alr -2(e)O^(5 i 3(P 1 CONTRACTOR EMAIL: b 1 ue S k 1 L I.6-[---tvo 6.,k i. )z +t- •,-CAA- <br /> CONTRACTOR LIC.#(REQUIRED):I1.11;75EC-q-39-C? CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Q C,(o03 <br /> PRIMARY CONTACT: 0 OWNER IhCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: '/?S"- 7 k rj r�3 j I <br /> Tii4o 0 'ci-t CONTACT EMAIL: 'ko Ls'SKl E i.t-'r.`--z-`<n0 i,J P..,9v'�-lie •C 0.^ <br /> AGREEMENT.'I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and inances 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 /> st En (3 - a�2 <br /> wner/A orized Agent Si atu a ate (Revised 9/23/2016) <br />