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,�—! ELECTRICAL PERMIT APPLICATION <br /> zoiliCITY 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 1 www.everettwa.gov/permits <br /> PROJECT ADDRESS: Z CO "✓[Q'ft 1 St J(N v - 1(-04-1.-- <br /> BUILDING <br /> rVBUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: S-F. 1l \v(0 Q) <br /> ttll - .... .. .;`: ,,, - ,PT ' A It a l"::c c 0#0 , % ., .... .. ..,-� , EP R.�.. . ; <br /> �II� <br /> CONTRACT PRICE OF WORK:$ 1.9?)QQ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES INO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: V \ t, II! }P'VV,, 1Z.QA/V 13 of eli <br /> • 2 C4{m l S <br /> • 20O 01 wt p pot t-e I <br /> p g ` T*f3i**1SDR M s ,Y '` 3s s <br /> OWNER NAME: l/ - GtOV - T( Vm TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ./"IV v lQ I-1/ Sr Jw <br /> CITY t re STATE \Pi 1+ ZIP ( t� <br /> OWNER PHONE 1\111' OWNER EMAIL: 14 Pc <br /> AR 1 4pvS€ IG+VCoV v <br /> BVI � /CONTCTOAME: VV � . <br /> CONTRACTOR ADDRESS: STREET 10 f <br /> 0 j <br /> Q[11 h D , Lf' y/�� <br /> CITY VA :/�,, ��T��eA/ s STATE �/ J ZIP I" j /� <br /> CONTRACTOR PHONE: �Zt �,0 3 Z3CONTRACTOR EMAIL: ih'e p-ivrnitS C� 9 mot I l . (xcvvy i <br /> CONTRACTOR LIC #(REQUIRED) O?SOl Z "J m CITY OF EVERETT BUSINESS LIC.#(REQUIRED):Q1441(90o <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L.{ 550 30 1 p(1 - <br /> 1<660 V V CONTACT EMAIL: Mr/r)f,v y/l 1Ts u Y 61;( vb/V ' <br /> AGREEMENT.'T hereby certify`tdat I have read and examined this application and know the same to be true and correct. All provisions oVaws and ordinances governing this <br /> 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 <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 is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 W, <br /> 4 <br /> City of Everett Official Use Only <br /> FEE <br /> *Aivi (00 0,0 <br /> PERMIT# <br /> Elk jffiV. <br /> 2_.2-(6.tic?) E igda - ?1 <br /> Owner/A thorized lirrtSi"(attire / Date (Revised 10/12/2015) <br />