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ELECTRICAL PERMIT APPLICATION <br /> °'. CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,INA 98201 <br /> (P)425-257-8810 I FAX 426-257-0657 1(€)everettepseeverettwa.gov I www.everettwagovipermits <br /> . '. eSITE INFORMAT O <br /> PROJECT ADDRESS: ,c E / . . 1( . i& 17> e'.}- <br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED C1 DUPLEX Q MULTI-FAMILY-#OF UNITS: Cl COMMERCIAL <br /> USE OF BUILDING:, "(1:7- — <br /> . ELEttRICAL A?PLI T1 . tiFoRNMATIION <br /> CONTRACT PRICE'OF WORK:$. ' D.. 570 <br /> NUMBER OF DEVICES(if 10w voltage): <br /> FIRE ALARM? L YES ,NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: /:AJ %" 1 /a- 'ic C- o J'` tC: �01)77-e ..,......° :` <br /> el <br /> 1it I 31 I/ r tI it - OA 1 e , Jc -� <br /> r r ,C) <br /> PP) c i. . V Peo.. e S.,17.4./... 3' g <br /> OWNER NAME: ° , t l" 1 A$S 44‘..-77-••33, TENANTrNAME If Commercial:. ..I` . ... <br /> OWNER MAILING ADDRESS: STREET i 49 t>ke 't o2i <br /> crrY 0-e pi ie. STATE 1✓ 010x' zJP g5-0 a <br /> OWNER PHONE: o"'9/1' - agOWNER EMAIL:& 4(,7 .G+1 G,4,/ .e$1i; s'r : `., n <br /> CONTRACTOR NAME: C „g. <br /> CONTRACTOR ADDRESS: STREET 7 /5 Fii eeetoy ?)4,0 _ r� <br /> CITY 17-7?)/04010 t //eel/47077 STATE G ZIP,g4�y / <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: t <br /> CONTRACTOR LIG. REQuiliem: .5/‘' L ?'..4 7 3—, CM!OF REIT BUSINESS LIC.//REQUIRED): .2,f ,,. <br /> PRIMARY CONTACT: 0 OWNER ONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ,.CD— ,: a`, <br /> 4,6()---r;_s 7 CONTACT EM 1ML: .,. ., . .,,,tff ,t , evasevit <br /> AGREEMENT:1 hereby certify that.t have read and examined thisappffcaIlCn and know the same.tobe th a andccarmct Alt provisions oftaws and ordirrar gaveming thistype <br /> of work will be completed whether whether veal&lzerekt or not: The granting-ea permit does not presume to gkreaulhorftyto violate or cancel the provisions of any otheralate or <br /> local law'regulating construction or Me performance Mc/instruction. That am authorized by the owner of this property toperform he work farwhich application is made and! <br /> comply with the State Contractors Law/8.27RCW and 296:200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> (.."? ,,,,i9 t j../..._ <br /> / C ier /g/' El ()CO—' $56 1 <br /> owner uth.rizedAgent Signature Date (Revised 9/2312016) <br /> i <br />