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(4#71E17 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 www.everettwa.gov/permits <br /> PROJECT S1TEINFORMATION _'„ . .;„ <br /> PROJECT ADDRESS: 30.0•5 w, CAS;tlo Ro, EV�IZE iZ Wim. B/40-SS 4-- 33 COL H-15 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) ii/A SF _./ <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ..COMMERCIAL <br /> USE OF BUILDING: INDDS- T-1AL- <br /> ' ; ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ (.001 pyo; <br /> NUMBER OF DEVICES (if low voltage):I� <br /> FIRE ALARM? 0 YES E1 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ADD t*iGt -leo V ReCEtPT Ci- S , i•11), 1)1 SCD).l MFC-T <br /> C tel e,e" PovV6K'-- <br /> CONTACT INFORMATION <br /> OWNER NAME: BOE►Nla TENANT NAME(If Commercial): .BOEI 1 <br /> OWNER MAILING ADDRESS: STREET 3003 tAt CAS 11 JD -p_bpcb <br /> CITY STATE WA-- ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: (k UQyA { CLec"T12_IC, <br /> CONTRACTOR ADDRESS: STREET 15135 NiE 012+.11). STC T <br /> CITY P-61).NI01 ,D STATE WA- ZIP of 00 52. <br /> CONTRACTOR PHONE:425.103, 1117 CONTRACTOR EMAIL: 3arU, (Q&1Gl.Yt.G{f'� 'e' ,5 j,{01,{pj/), COyyl <br /> CONTRACTOR LIC.#(REQUIRED): 9 SEA jficLg 77,59 CITY�OF EVERETT BUSINESS LIC.#(REQUIRED):UI040 645 <br /> PRIMARY CONTACT: 0 OWNER LCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: ' CONTACT PHONE: 4z6,/_903, /717 f_ <br /> �i4Jey pRCt1e(i1 M�kt�lt CONTACT EMAIL: p�Yy KJL!/� g>a� a� �(��//Ge/ Ce7m <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be�tfue and correct. All provisions of lea and?srdinances 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 /> 41 <br /> 111111, City of Everett Official Use Only <br /> .40 PERMIT# <br /> iA t ( E 1 7 1( <br /> Own r '77" signature Date (Revised 9/23/2016) <br />