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ELECTRICAL PERMIT APPLICATION <br /> On-Y. J.- Ev.RoTT?ERN/1i-J. V!l CJ <br /> 32D.? CL-DAR STREET, EVERETT, WDA 93201 <br /> 425-257-3357 i E_, ;/ r aFI J5@,04'si f wa.rgoit i 4lU w.everul°' a y'ovie7eccrt,r:; <br /> PROJECT Stre:INFORMATION <br /> ,2RDJECT ADDRESS: d►i" f W r <br /> i <br /> tle <br /> � . <br /> µ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: S '?5,'—) , <br /> :'4UMBER OF DEVICES (if low vD1t33 ): <br /> FIRE ALARM? 0 YES D NO <br /> ASSOCIATED BUILDING PERMIT# az:)ialIcaWe.) <br /> ___. Ea'CR1E [.Ct.SL.OEWORIC: ,k <br /> t . <br /> /,,I i,,'' ` LI <br /> iiiiin. <br /> - �GON TAcT IiirtiRNIAtrIOND4V6IER SAL;;. <br /> •ENA`aT N4ME`If C3mmatraia►}: <br /> IDS NER MAJLINia,ADD <br /> � .�: _ % ' <br /> i D4TRL Di Si€bf ^ ''± <br /> i r <br /> C ` <br /> Dc4TRACrz__- !TDR ADDRESS: -' 1 t 41.,,,„ ;.‘— <br /> vQNTRACTOR PHONE: _ �� Cm : <br /> � ' if, ge20I <br /> _ CONTRACTOR EMAIL: • % r ' a <br /> ED :CY' it'„ • „_CITY OF EVERETT BUSINESS LIC.7iq,s�OUREtl: _. _ - <br /> PRIMARY CONTACT: 0 OWNER j ! <br /> CO.\ITRACTOR 0 OTHER(please Specify) <br /> CONTACT NAME: j <br /> n CONTACT PHONE: 1-1Q6 abq 4) <br /> I e�le CONTACT EMAIL: do 1y`.� <br /> AGREEMENT I hereby certify that I have read and examined this application and know the same to true and correct All ov dan , <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to glue authority to violate or cancel the provisions of any ether state or <br /> local law regulating construction or the performance of construction. That tam authorized by the owner of this prcperty to performthework fcrwhi h applicand tion is made and type <br /> comply with the State Contractors Law 18.27 RCW and 2S6.2CC WAC. <br /> City of Everett Cfclal Use Crty <br /> f-ilJ PERMIT <br /> b- Ut <.. -• °7 I S--- —6 <br /> 1 <br /> C., ,,,artr „,,ri.ten A er, c _r E �� �� <br /> t gcature <br /> Eae <br /> (Revrsecl 5/23/.:C1E; <br />