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LLECTICAL PERMIT A LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION': <br /> PROJECT ADDRESS:CM-06 -k ms.` - t L.* 4VZ2-ept <br /> BUILDING AREA(if residential,new construction, remodel,or addition) '`'''.2-010%-x- . SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: pCOMMERCIAL <br /> USE OF BUILDING: C1�OI • <br /> •ELECTRICAL AP° ATION INF•RMATION <br /> CONTRACT PRICE OF WORK:$ 11.2.1®ocj <br /> NUMBER OF DEVICES(if low voltag- <br /> FIRE ALARM? 0 YES a <br /> ASSOCIATED BUILDING PERMIT#(if applicable): '146,0(, <br /> DESCRIPTION OF WORK: <br /> • <br /> C.� Q Jac"%lt C <br /> CONTACT` INFORMATION. <br /> OWNER NAME: �W ` Z <br /> �ov .r.k-1.4,k -p , \ ScLs S TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 6\S-06 94 K. <br /> errs( ` "°kSTATE fV..9 ft ZIP a. .t <br /> OWNER PHONE: 42-.. 6e40,---goc3-O. OWNER EMAIL S'T S@ ScA,cow ..s. k e Go <br /> CONTRACTOR NAME: O <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACTppNAME: CONTACT PHONE:(Z �' S p c.(3 <br /> /- c( <br /> Cores.kc w Lep - CONTACT EMAIL: �i�� �� �k ,_Cfizz)1A.,‘ <br /> AGREEMENT.:T hereby certify that I 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 /> PERMIT <br /> , CoE (9°Co- <br /> ice, ZC <br /> o <br /> ' (2s4tT <br /> Owner thorized Agent Signature Date (Revised 10/12/2015) <br />