620 112TH ST SE SPACE 375 2019-08-16

4rEir ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6 .2_ [ (27 T Sc /4378 BUILDING AREA(if residential, new construction, remodel, or addition) /RO/ SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL + . USE OF BUILDING: /1�1r� i� &t- 1J Q! ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2- NUMBER OF DEVICES (if low voltage): FIRE ALARM? YES NNO ASSOCIATED BUILDING PERMIT,#(if applicable): G'is 000 OC f DESCRIPTION OF WORK: Hod K.(k\-.3 (4, 1/4.01-NJ V I=A-C2-1)PJ J J-(o i 7-co CONTACT INFORMATION - OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET -t--/ x IL Ae CITY kb 8 Z,\ STATE Vs-3f1/4—. ZIP eif J L3 OWNER PHONE: f2S--- /-CJ( (o to Z(o OWNER EMAIL: CONTRACTOR NAME: lb w N 712 - CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ,DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: C. .cl.p C��C- _CONTACT PHONE: 1_ZS- ( 6,6 TSU Ate- )--C co, AA,kJ s CONTACT EMAIL: C Je..c t� �f��n� l , Q , AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and rest. Alh visions of/a and ordinances governing this 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE roe PERMIT# E - << q Owner/A t.•rized Agent Signature Date (Revised 10/12/2015)