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Jew_ <br /> PLECTRICAL PERMIT ALICATIO <br /> -- CITY OF EVERETT PERMIT SERVICES <br /> NIIIIII _ f <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 SITE INFORMATION <br /> PROJECT ADDRESS: 7rUi 1 HlV\1 d Y 4 \g.• <br /> BUILDING AREA(if residential,new construction,remodel, or addition) Y..e5CI Inti(I I SF <br /> BUILDING TYPE: ISFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: GI S k- Woe.JV A <br /> ECT AL P CATION INFORMATION <br /> CONTRACT PRICE OF WORK: r;► i `, a,r <br /> NUMBER OF DEVICES(if low voltage): i <br /> FIRE ALARM? 0 YES o. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 2 V\( I /c03—U O <br /> DESCRIPTION OF WORK: p5 k t t-((f Y (U A p(2-- kt -vv� 1.p . - <br /> � 1VOl'a LIt`I tc . Wb1, al \ re tv( � . <br /> Inea ' . <br /> ` L) 03 -co S <br /> CONTACT INFORMATION <br /> OWNER NAME: \ ' \WN.,1 I(t,M '1t.L TENANT NAME(If Commercial): <br /> .. <br /> OWNER MAILING ADDRESS: STREET (g tit- r p 1 pz. #2I 00 <br /> n' CITY cta STATE t A ZIP 'IN V I <br /> A <br /> OWNER PHONE: UI- LJI.OS- ISS k S /,OWNER EMAIL: in I111^. i1/'M1 Il.(J'n2 t e or k 1 ,(04^N <br /> CONTRACTOR NAME: OWO � , _ . _ <br /> CONTRACTOR ADDRESS: STREET �"^C <br /> r <br /> CIN _ _ STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: . Nw..,. <br /> CONTRACTOR LIC.#(REQUIRED) „ „,3 1_3 . CITY OF EVERETT BUSINESS LIC:#(REQUI ED): ' <br /> PRIMARY CONTACT: I5/OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: lX UOS- 6 1,3 <br /> g� CONTACT EMAIL:a�� , <br /> in►c)��►�-ot ions tonal (� �yv�a k _ cam <br /> AGREEMENT;;T 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 <br /> type 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 1 am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> q5 r_____ <br /> PERMIT# <br /> t bWigE...i.):::)#iteacs <br /> Owner/Authorize tSignature Date (Revised 90/92/2095) <br /> Swig/loaf <br />