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01-14L- 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.gov/permits <br /> PROJECT SITE INFORMATI©N. <br /> PROJECT ADDRESS: 11130 ow Ew-ie.il fiat{i Logy <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: rA A'Vhe cl A I <br /> ELECTRICA 4Pp41GATION INFbRMAt ON:' „ <br /> CONTRACT PRICE OF WORK: $ Z-oC7 <br /> NUMBER OF DEVICES (if low voltage): I <br /> FIRE ALARM? 0 YES XNO <br /> ASSOCIATED BUILDING PERMIT#Of applicable): `� <br /> DESCRIPTION OF WORK: _L(15+a(I C V'1 tip *Aral <br /> L ++'' (( re <br /> II 1 1 CONTACT INFORMATION <br /> OWNER NAME: STfickland Imo( SrA I� ��df��S �� TENANT NAME(If Commercial): Fn iorpi;fjc rei►-ba- cetr <br /> OWNER MAILING ADDRESS: STREET 12-(q9 tit')lay Q k.r 4 <br /> CITY 1 I IA t f ko STATE IDA ZIP ft1 5 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: CFM � Auld Cootir <br /> CONTRACTOR ADDRESS: STREET F-2'. VOA 32-05 <br /> //�� CITY 1�1 ( Let AA ZIP '006_3 <br /> VV_3 <br /> CONTRACTOR PHONE: '(25 67 t" /ZY3 CONTRACTOR EMAIL: T Xelny C EGM` if VIA CCOAA <br /> CONTRACTOR LIC.#(REQUIRED): CFMNk FIM q15 3QT- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER ,j&CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L(Z5'3bz- 52-06, <br /> efeiKy Moller- CONTACT EMAIL: 0orevi&9 GPM F)V4O2.COM <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 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 /> Owne Author ed gent Signature Date (Revised 9/23/2016) <br />