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4err kLECTRICAL 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: 2:2—t t 'J, C k$(.(fib VOCC) <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ,OMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ -7'51)00 =- <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Wtb..l o • L Nc, Ft.(2.. -o T., s ---C\--74:,43 <br /> 4t-- !�-�0 Vie--• ��\�- C5/. t�T <br /> -- NV RO0C._ k--CQ ZgtOVIA <br /> CONTACT INFORMATION. . <br /> OWNER NAME: TENANT NAME(If Commercial): liCf t t c-& <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: L4JJSca_ `= C _ C <br /> CONTRACTOR ADDRESS: STREET 3 OZ Log' St S C ¢� <br /> CIN (2., iz_l l ( STATE LJIA----- <br /> ZIP 61, G-�'`!3 <br /> CONTRACTOR PHONE: S— CONTRACTOR EMAIL: Joh `1 fft"eoar-P -Z c-- i'ic_Q—cOv -C& t.v%-a---t— <br /> CONTRACTOR LIC.#(REQUIRED): L.UUEA 6L)936 i') CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0.5-3-5 4 <br /> PRIMARY CONTACT: )OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Lt7 --) —5-5S-CP <br /> aCt.- C)k CONTACT EMAIL: )o--\t"...-Co,r`.e l.-e c 44.71.._. e, coil— Lct ,Y.o..4— <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/am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> Lii, Do <br /> 11 5-O . <br /> PERMIT# <br /> / <br /> i -4 z-z0-ig E 1(662-I C <br /> o uthorize••Age S ••nature Date (Revised 10/12/2015) <br />