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R <br /> ECTRICAL 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 www.everettwa.gov/permits <br /> PROJECT ADDRESS: Q7 f/6 Stikte Sk . S T E So <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: ryi Air.;J/,tom C{ <br /> +a i nth c: ogook`4#0:4010 :00** . �a" ti az a '� �?" r, t w. <br /> .. ..�.�,_.. .. ..�..� ,- 1. ,.,<.. ...�,.,. ,,.�.. _�. .a ><�a�z..aw. ...,...1�^�.. . � �, .� �.. .. _.. .,�.,.x .. _,.w. .a�._. .,_ .amu., <br /> CONTRACT PRICE OF WORK:$ 1,500 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): n}A y <br /> DESCRIPTION OF WORK: (\Q&. pc x'.z — la X1.0 Le <br /> CONT S 1NFORMOION <br /> OWNER NAME: RI-) P i\ -60 LD C N.) TENANT NAME(If Commercial): ` -k-A c,L.l7 E NJ <br /> OWNER MAILING ADDRESS: STREET g q/to 5'E' She. ? <br /> II CITY �v e_tr�ff STATE �( , ZIP <br /> OWNER PHONE: 7LLe, 5 7`f - a OWNER EMAIL: <br /> CONTRACTOR NAME: SOIec_ c_ <br /> CONTRACTOR ADDRESS: STREET D ccs 1` C-t r\c <br /> �^7 <br /> CITY Vt 1(\Ot1Y STATE WT\y ZIP ' '2.2.3 <br /> CONTRACTOR PHONE: ' d2 Co 30 ,"i 14' 1 CONTRACTOR EMAIL: 0.�2�V�9. S¢l� �G.��c l�- Ce m <br /> CONTRACTOR LIC.#(REQUIRED): C 1 *c34 2.D2- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Gj�prj�� <br /> PRIMARY CONTACT: $OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> •CONTACT NAME: CONTACT PHONE: -71-10 - Q 7L/ - 003—D <br /> R o,,v, \-3D k sr) CONTACT EMAIL: <br /> AGREEMENT.-I hereby certify that 1 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!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 /> /OA)4 E ( q t o — 0(01-1 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />