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ELECTRICAL PERMIT Alt3ILIC A.TIION <br /> .f. 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 /> IPS OJ)lacT SITE IMF r' ATII IN <br /> PROJECT ADDRESS: 332 51 Ever- <br /> BUILDING AREA(if residential,new construction,remodel,or addition) re vnc 2 I SF 5 000 <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1 COMMERCIAL <br /> USE OF BUILDING: I/VI 0,�, ;_Ce v nt>4 +- C Q pnPv7e1rC 1 A( b U o c I VI�. work perf 3 W12G 1�1-t5a e <br /> EiECTRDiCAL;APPUCATi®Iti <br /> CONTRACT PRICE OF WORK:$ 1,0 OQ <br /> NUMBER OF DEVICES(if low voltage): ( 6 <br /> FIRE ALARM? 0 YES IA NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: CLW Voll-one Jevke.5. 6card o cce55 ciOor$1 c a wl e ras <br /> O.nc1 2 0/420 n5, <br /> i q o -Dmf <br /> _ <br /> OWNER NAME: R u g y 6,,ryit.0 r TENANT NAME(If Commercial): to►��a% �a <br /> OWNER MAILING ADDRESS: STREET 332. .SGJ E verr+f' ( c S plc 3 <br /> cnY Eyre STATE W A ZIP 9820 U <br /> OWNER PHONE: 91t)-32.(-3/(5p 3 OWNER EMAIL: Rc loIpk c�0, Cr LA.491.9/?elo.k k..c0P7-i <br /> CONTRACTOR NAME: Nelian £i I ec+rrc r. 1 nC- <br /> CONTRACTORADDRESS: STREET 72o 5-Fore Ave Mo,r-)1i, SU.)+e 2l <br /> CITY Seck-�-Ie t STATE W A ZIP 9'8"103 <br /> CONTRACTOR PHONE: 2.Q&-523-4 25 CONTRACTOR EMAIL: k'i.,i7[bur ne(sayie(ec.CQPY/ <br /> CONTRACTOR LIC.#(REQUIRED): N EL 5QE 1132 CZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):00.:91470 <br /> PRIMARY CONTACT: ❑OWNER 12 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 0 f _Q — go 15 <br /> Toe, Roo CONTACT EM� : rap-1-11010 & <br /> ne we ec.c 040AGREEMENT.`:T hereby certify that!have read and examined this application and know the :..e to be true and rrec. All provisions of laws and or.ham,-governing this <br /> type of work will be completed whether specified herein or not The granting of a permit does not p= - o give au. _-• - . .-e or ca . -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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> I FEE <br /> Cj©o �i <br /> PERMIT# <br /> F1:160friOq,0 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />