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ELECTRICAL PER 1IT A.P L CATION
<br /> _. ,_ CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: GS 32 _ ,, _ ` --� ;. �. 35-20 64 �tc,c� �ji.�
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF • J
<br /> BUILDING TYPE: 0 SFR-DETACHED El SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL
<br /> USE OF BUILDING: 437a ,:::#4,1,,,,, - ,5 2/' 74" 74,4.T2l __
<br /> ELEC' RiCAL APPLICATION JI NP®R>iI1110i0i
<br /> CONTRACT PRICE OF WORK:$ 4..5,O 7O --
<br /> NUMBER OF DEVICES(if low voltage):,
<br /> FIRE ALARM? 0 YES ❑NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): foss' 6!". -1-7"De a x-rGi d�/G)-e-et (ZittAt_ 11495.24—)
<br /> DESCRIPTI��� .(4-)75,40,")
<br /> f�,,a, sJ a t.i / 't/ 74-4 r elsy d'//�"" `, * J
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<br /> �.:.-. ._.. •CINFORMATION .
<br /> ONTAC. . .:...T =
<br /> OWNER NAME: 46449 1? C4/. s l/( TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET 720,0 Z4 ,- J`
<br /> err( f1/41.4.-714/4— STATE 47,":71— ZIPSZ1.2/
<br /> OWNER PHONE: OWNER EMAIL: /
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<br /> CONTRACTOR NAME:
<br /> CONTRACTOR ADDRESS: STREET '
<br /> CITY STATE ZIP
<br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: '
<br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED):
<br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: L✓Zc .. 5.-00 ../5 la
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<br /> J-U£d`Jo-,/e CONTACT EMAIL: c1/iia,/4944. y -.e ve„,e k✓Gl , ,of
<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 g8 erning 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 I 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 /> FEE
<br /> I
<br /> PERMIT#
<br /> Owner/Authorized Agent Signature Date (Revised 90/92/2095)
<br /> y_i_____
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