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i#411Pd74 ELECTRICAL PERMIT APPLICATION <br /> CITY OFVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8310 I FAX 425-257-8357 I (F)?verettaps@everettwa.gov I www.everettwa.gov/permita <br /> I'RC_ T SITE INFORMATION <br /> PROJECT ADDRESS: 4,AraIp <br /> BUILDING AREA =, •#i til <br /> Ur ,�. 7 <br /> 3 t,_DlN3 TY c �:�i� =3 >=� i,T% 4� `� 1 `�; {( <br /> ry 1 37 <br /> t..D rIY J. <br /> ELECTRICAI:,APPLICATION INIORMATION <br /> CONTRACT PRICE OF WORK: $ 2 C7 .a' <br /> NUMBER OF DEVICES "if low volt:a-a}: <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> DES CRIP,:T1Q.LOE.W ?ELECT_ _.---.___ <br /> OWNER NAME % <br /> 0 'ort ` . — TENANT NAME If Commercial}: <br /> OWNER MAILING ADDRESS: __ nP0. --� <br /> 4 WA <br /> OWNER PHDNc: 3110"E, p t.20 <br /> 04, w .rr • OWNER EMAIL: <br /> Ot;TRA:TOR NAME: i ^ „ <br /> C <br /> LA <br /> CONTRA:TOR ADDRESS: t re— <br /> CIN ...�.A. ,r� IP qz 2.0 1 <br /> CONTRACTOR PHONE: ^' STATE A '`"�-� -' <br /> ,4 q 0170p . CONTRACTOR EMAIL: I ,40 f <br /> _ CONTRACTOR-12C. (R#_'�t1itcC�): 1 _ - � .4/4 440 �r •, � A /117CITY OF EVERETT BUSINESS LIC.#{Ri OUIRED}: s a w <br /> PRIMARY CONTACT: 0 OWNER ti CONTRACTOR <br /> 0 OTHER(Please Specify} <br /> CONTACT NAME: <br /> CONTACT PHONE: ( t <br /> I ie CONTACT EMAIL: <br /> AGREEMENT.I hereby certify that!have read and examined this application and know the same to a true eb$nd correct. All provisions •corn <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 thece p vis+ons of taws and ordinances governing this type <br /> onsruct <br /> c296t 00rWAC.That I am authorized by the owner of this property to perform(he work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 CW and <br /> City of Everett Cfpciel Use Only <br /> � <br /> y, <br /> PERMIT# <br /> _±.2:32,:jt___ E '? ,b - l S3 <br /> ....__ <br /> Ctvr;@YtR!<(tt;Ar12@d Agent SrgnalU re <br /> Cate <br /> (Revised 9/23/2010 <br />