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2_92,0. 21 6, bff '3• . <br /> ELECTRICAL PERMIT APPLIC, TION <br /> #11101010,4idg; CITY OF EVERETT PERMIT SERVICES <br /> - 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-•257-8857 J (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> „ A4 <br /> PROJECT ADDRESS: b- 3 r ..\\dA Vc,„ (In( VY)v� _ <br /> BUILDING AREA(if residential,new construction,remodel,or addition)) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX El MULTI-FAMILY-#OF UNITS: NI COMMERCIAL <br /> 11.1.2!BWLDING: pe'l'g6 EVERETT- <br /> : <br /> VERE T'.. ... .... .._<:�.� . _.,....,_..,. ., - ,..:.. <....,:,.-��� ., : ., .-_.., .. . • ., � . ,. ,- <br /> CONTRACT PRICE OF WORK:$ I 2 000 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: -tr.\S-4-'C. \ CI() J it o - -v (d <br /> ken ft <br /> • <br /> CONTACT INF'ORIVIATIION. • <br /> OWNER NAME: TENANT NAME(If Commercial): i/}6 <br /> OWNER MAILING ADDRESS: STREET Pc &2)( 3707 <br /> ewe .5Ei TT-L.E STATE 11/a 1 413/Z'/-22O7 <br /> OWNER PHONE: �1 �, OWNER EMAIL: <br /> CONTRACTOR NAME: ,V <br /> i i_ ( sTeuL�TIDk) <br /> CONTRACTOR ADDRESS: STREET Po 8.OX 4/p <br /> CITY) ma /1 <br /> -TED Q SrATEV 4 ZIP9g2LJ4 <br /> CONTRACTOR PHONE:426-2/4 4"/44 CONTRACTOR EMAIL: k4-/e./ Hiiinn')EfQ0)ki w/r &?/n <br /> CONTRACTOR LIC.#(REQUIRED): ��III�� C OZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):02)05g1 <br /> PRIMARY CONTACT: 0 OWNER 181 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 204,-736-654-4, <br /> PCNN 1 S Ce.oW CONTACT EMAIL: DENN JS.CK•01.t)0 OE-MT. &0I31 <br /> AGREEMENT:T 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 <br /> type of work wilt 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 t am authorhed by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 ROW and 296.20d WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> IU E Ft0C - 0S0i <br /> Owner AujiiorizedA6 t'Slgnature Date (Revised 10/12/2015) <br />