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MIECTRICAL PERMIT A.P1� ATION <br /> Niowl - 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: D6 0 8 (A)cit( wt 51 <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: 0 COMMERCIAL <br /> USE OF BUILDING: 5.FA <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 31000 <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): j <br /> DESCRIPTION OF WORK: Pet h,e/ /e ip I q e/�ie/ev+e rail - 12,-O{ 7,1c 2, CI,G T ai (/p S4"4,e¢J <br /> c_V ' J t l� l 4,,k- ►, <br /> k-Kce <br /> CONTACT INFORMATION <br /> OWNER NAME: 7 , /I; - k O Me.,e., TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET a 408 ` :Lti c,/,,,1I I- S . <br /> �7 pCrrY ridl.4 Lie-ti STATE L 4 ZIP 9 p 02/ <br /> LOS OWNER PHONE: �� 7 7 /4'f 9 OWNER EMAIL: <br /> CONTRACTOR NAME: Se,/te e Cf•c1m-rc4i Sey vice 5 <br /> p J <br /> CONTRACTOR ADDRESS: STREET o1./c' I IV (T o k e ha tL- ✓�.CI J� <br /> CIN SNO A(,11.31 k /' STATE �/.4 ZIP q 7e <br /> n 1 ) 1 i <br /> CONTRACTOR PHONE:las- 397 7 ©a CONTRACTT'OR EMAIL: S F/NO 4 Se HOC('k C 7r, Cci/_ C.0 WI <br /> CONTRACTOR LIC.#(REQUIRED): SCL.7— �876 k T' CITY OF EVERETT BUSINESS LIC.#REQUIRED <br /> .... w..az_r .. ..,..__ ..._.._. .�......v... �_....,....r__�a..,..v ...�.�._n_.... _..W...m,.,�....,..w...:.........�..,. ... �.s . .w...? r/ r <br /> PRIMARY CONTACT: 0 OWNER 4 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Lia T'' 3 9'7 - 900 <br /> ., 9) T) L 1,1 Z., CONTACT EMAIL: <br /> AGREE ENT: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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> . CO <br /> • <br /> PERMIT# <br /> MLlot—grig 7//? olp E t q \ pa— <br /> Owner/A horized Agent Signet Date (Revised 90/9212095) <br />