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06/2412006 03: 33 25328821 9AOrt7r
<br /> GARNER ELECTRIC PAGE 01/01
<br /> ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT � -,., .. .. .. ,, �., ,�,,° �:i�,4t�.:. . ,.,. ,>,. ` �{� rl�.� . , `.,r...� ("d �
<br /> ADDRESS: � ,�
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<br /> BUILDING AREA(If residential, new construction, remodel, or addition) SF
<br /> BUILDING TYPE: r]SFR-DETACHED ❑SFR-ATTACHED El DUPLEX LI MULTI-FAMILY-#OF UNITS:
<br /> COMMERCIAL
<br /> USE OF BUILDING:
<br /> ININI
<br /> #011 , d� r.. ar� ..'� '�Srf'Ft42tN y� ,>:,.'""!.�.o« ;,.�i"` L7l.C'Gt�t?�i!':.:L a°L�,r^r. ?`,',,'.^'�tCA ��iimViiI �J, '1� �fkVkS1�7i�'3a`t�y., • 'J]ty•y (C%v'”*i f�{�«"i zt ,a
<br /> �l A Y"W dc.':on I.M •d.a'eln! .d>..k' flT ... t�Q ,
<br /> CONTRACT PRICE OF WORK: $ ,Cab "
<br /> NUMBER OF DEVICES (If low voltage):
<br /> FIRE ALARM? ❑YES El NO
<br /> ASSOCIATED BUILDING PERMIT# if a.•licable :
<br /> DESCRIPTION OF WORK, Illir
<br /> 11 : ' -'IAIr
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<br /> OWNER NAME: Pe tit ,g Atli AA 'A TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRE : STREET E , -
<br /> i . ZIP /vJ��-;tcj
<br /> _` CITY r` • V'
<br /> STATE 1��"'�
<br /> OWNER PHONE: !�— 411121, •- OWNER EMAIL:
<br /> CONTRACTOR NAME: -' _ A -
<br /> CONTRACTOR ADDRESS: STREET mil ', , , i��
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<br /> STATE
<br /> -- CIN
<br /> --CONTRACTOR PHONE: r r +� A
<br /> ZIP q'
<br /> I�—(0CS/ CONTRACTOR EMAIL: V
<br /> PRIMARY CONTACT: d OWNER ._- ', CONTRACTOR +AR `� CITY OF EVERETT BUSINESS LIC.#(12EgUIRED):b 5�
<br /> CONTRACTOR LIC.#REQUIRED _
<br /> ....
<br /> (Please Specify)
<br /> TRACTOR D OTHER
<br /> CONTACT NAME: CONTACT PHOr,E. s
<br /> e-. CONTACT EMAIL:
<br /> AGI1EEMNT:T hereby certify that/have read and examined this application end know the same to bo tole and correct. ill provision'of laws and ordinances-governing this
<br /> type of Work will be completed whether specified heroin or not, The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stet°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 la made end I
<br /> comply with the State Contractors law 19.27 RCW end 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> 2.0f) ,--------
<br /> / PERMIT#
<br /> r., ' 1/ i E Ce(( - 2CS
<br /> Owner/Authorized Agent SI•nature
<br /> n` o (Revised iCv12/7.015) ��
<br />
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