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ELECTRICAL X11 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 f(E)everetteps everet a.gov 1 www overettwa.gov/permit$ <br /> ICarsite IFIFORMATIOII <br /> PROJECT ADDRESS ti 5C) °. <br /> BUILDING AREA(ifr Mist,new construction,remodel,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED El SFR-ATTACHED CI'DUPLEX Cl MULTI-FAMILY-#OF UNITS Cl COMMERCIAL <br /> USE OF BUILDING: 4.5?t <br /> CONTRACT PRICE OF WORK: y_ (10 — <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALAR ? Cl YESI:3 NO <br /> ASSOCIATED BUILDING PERMIT if appt cable): <br /> DESCRIPTION OF WORK: SA. c , ec)kact, -vt,,fre , - . .(1u -4,c 49,, <br /> t ) <br /> CONThCT INFORMATION , <br /> OWNER NAME: r VLit.p 4_ 13er TAI EJIf Commercial): <br /> OWNER MAILING ADDRESS: STREET I0 <br /> coy c-,it t sei,,l+ STATE tO A ziP CI 1 e>0 1 <br /> MINER PHONE;E: t. —'WCI-" Cr ER EMAIL: <br /> CONTRACTOR NAME: (t - 4 'cx Ns. , y.".c-. . <br /> CONTRACTOR ADDRESS: STREET q <br /> CITY- +.?k°. .STATE. % MP <br /> CONTRACTOR PHONE: ; -�` S- t. CONTRACTOR EMAIL: . . :Drift Vr' .e el <br /> CONTRACTOR LIC, REQUIRED) ViCk...WSE,., a VAX, CITY OF.EVERETT BUSINESS LIC.(REQUIRED): Oter1441.00 <br /> PRIMARY CONTACT: 13 OWNER LeCONTRACTOR CI OTHER(Please Std), ., <br /> CONTACT NAMED CONTACT PHONE: a., _ --i"1 - 4 4 - <br /> c e t« ' LC, c .. ,CONTACT EMAIL <br /> AGREE NT.•I herebycerbly that I have read and examined flits applimtroi and know the same to be tree and� Aft previsions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not, The granting of a permed does not presume to ghe authority to violate or cancel the provisions of any otherstate or <br /> local law regulating construction or the partomtalice of construction; That am outflanked by the oar ofthis proper y to perform the work for which applicaation is made and t <br /> comply with the Stale Contractors Law 1827,RCWand 296.200 WAG. <br /> Oily of Everett Use Only <br /> PERMIT <br /> E ��D -0� <br /> 3gyk� t{�r'r` <br /> 0 r,,`A,, 0' cot Signature Q . (Revised 9i23/2016) <br />