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477 ELECTRICAL PERMIT APPLICATION <br /> 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 /> PROJECT'SIITE INFORMATION <br /> PROJECT ADDRESS: Jet er// (;d/?4/i'dh ,WAZ/,M/4,4 76.71t `� �� l✓ ^t' 6L �1� ' <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 37 / SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS:.,23. j,COMMERCIAL <br /> USE OF BUILDING: k )__ <br /> ISLE TRICAL APPI,IGATIQN II F+[3(I filAtiO <br /> CONTRACT PRICE OF WORK: $ 2)/ '<Z. �7 <br /> NUMBER OF DEVICES(if low voltage): SJ <br /> FIRE ALARM? OYES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: hey if�7C4Z/ /e X7/1 ,,1 <br /> . - ';:9604T4-0T INFORMATION <br /> OWNER NAME: -Litre 7 f�l1CGr/r TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS:/ STREET C /6/2 <br /> /JId� /CCITY Ly <br /> STATE . ZIP ?z9g7 <br /> OWNER PHONE: 1z'- S3-1/.3'D OWNER EMAIL: <br /> CONTRACTOR NAME: , GiM 5 u d/& '-S aiib1 LL_- <br /> CONTRACTOR ADDRESS: STREET 3--r7 /11,//y61.4 -- // <br /> CITY �- � � G-'( STATE PV/A1ZIP fs /(�/� <br /> CONTRACTOR PHONE: , /f d- 2 CONTRACTOR EMAIL: SCCiii /"56(//1/4 1ei1) <br /> CONTRACTOR LIC.#(REQUIRED) .5G'Gi/ASre6, e CITY OF EVERETT BUSINESS LIC.#(R QUIR,ED) 677 <br /> PRIMARY CONTACT: 0 OWNER 1,4 CONTRACTOR 0 OTHER(Please Specify) -dr (gp' 14( 1 ,rr <br /> CONTACT NAME: / CONTACT PHONE: 34:6 - Q/,-,d i°'+C:% <br /> CONTACT EMAIL: �6-'1 rie//S4'Gi/// f' c} lL//e e t-7,07 <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E \,$o2 - t,99 <br /> Owner! uthorized Agent Signature Date (Revised 9/23/2016) <br />