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/001111, --___, ELECTRICAL PERMIT APPLICATION ,, -, CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 j(E)everetteps©everettwa.gov] www,everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I-4C0 t1.3"0"` c c>--- Euerc4-4 4Cl i i BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED- 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: o pt-}fit ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ Li3OO• NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: D t i vb'y ) p t'e__ c.v c .. c rt "V-0 r 5 cle_cc�cc4cc( /Torr'tc ?Oc-oCi- c�i-C-L-4-i fS 0 r- Pc li;vcc.�i 1?-0604. -t-r-cuej tiS deme 5Ir& i, CONTACT INFORMATION OWNER NAME:P`'o0;c1-,‘612Src c Acet'6 ( TENANT NAME(if Commercial): OWNER MAILING ADDRESS: smeai I So I L i-v d ituE scA ArT0t4 � crer Reit, STAT: A/71 71P g5— OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: V rc4 £Ic fr;� CONTRACTOR ADDRESS: STREET &l'11 S 4U; 14Q c aC�G-`1+&. STATE Zip' / /OS Y CONTRACTOR PHONE: 2.C6-43&-5200 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): VECAtGT 5'-E Z h' 0 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):OO L(ct 4-1 5 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR )OTHER(Please Specify) j---.`e-Ic(. &c i ,- ( F4rc: q CONTACT NAME: CONTACT PHONE: 2.06 - 5-0- 713 6g t �q5o� edie�t4icI t CONTACT EMAIL: j4sca,5cHc`.�' %4(.) &. V Cl¢,ce141 AGREEMENT.•l hereby certify that i have read and examined this applicationand know the same to be true and correct. All provisions of laws and ordinances governing this type <1.---- 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 local law regulating construction or the performance of construction. That t em authorized by the owner of this property to perform the work far which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAG City of Everett Official Use Only PERM11,# er/Authorized ant Signature pat (Revised 9/23/2t 16)