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k 'I CITY OF EVERETT PERMIT SERVICES .., <br /> T <br /> 3200 CEDAR STREET, EVERETT,WA 98201 i <br /> , t <br /> t"' .., (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> ' <br /> 1. ' PROJECT SITE INFORMATION <br /> i'c`E PROJECT ADDRESS: 33 I I AY* c:•J`. E e c <br /> K ry <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF li <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> ;, . USE OF BUILDING: �eSi a &k C _. _ �- -.: <br /> �t, , _ ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ I 9 OO <br /> NUMBER OF DEVICES(if low voltage): f — <br /> FIRE ALARM? ❑YES IS,NO _ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Re Oa(e peine I l i U----M- U A LI 00 G w\ SK_v a-, <br /> pfe viols paAel A;c) n hc,„t ,mc.,\ t.-„y1,4-4- <br /> , <br /> - +e--4- <br /> _ <br /> CONTACT INFORMATION _1 <br /> OWNER NAME: 1A(K <br /> TENANT NAME(If Commercial): 1 <br /> OWNER MAILING ADDRESS: STREET 31 I <br /> cm u Eil e c e.-H- STATE /\ '-'i TM 1 na 9 _ <br /> OWNER PHONE: 9 25.- 61- I'� till C25 OWNER EMAIL: <br /> CONTRACTOR NAME: Da3Z E-leC}-rtCa 1 Service LLC <br /> CONTRACTOR ADDRESS: STREET -3 0 1t\A 4 i soiA. c-f--. <br /> cm? Ev -e.-7L k STATE Li A zip 1 8Z '' <br /> CONTRACTOR PHONE: Li 25-232. 13 61 {CONTRACTOR EMAIL: c)A 31 .e (e LA-c-1 L jMcx t I •C 0 <br /> CONTRACTOR LIC.#(REQUIRED): E C 0 A ZEES 8 7'-4 BLI CITY OF EVERETT BUSINESS LIC.#(REQUIRED): S e I i 8 <br /> PRIMARY CONTACT: ❑OWNER I CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Li ZS` 2-3,2-130 i <br /> Mut-4- <br /> F‘eW CONTACT EMAIL: GdZe' (E'(.-4t-;LpMCu1 .COM <br /> AGREEMENT'T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions bdaws 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 Y <br /> local law regulating construction or the performance of construction. That lam 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 ROW and 296.200 WAC. City of Everett Official Use Only <br /> FEE <br /> 3 1 OOP . <br /> PERMIT# <br /> i Di 1 ,i, E ii016q) - bq _ <br /> ‘7)/C(/;ea-2e" � r (Revised 10/12/2015)Owner/Authorized Agent Signet!re I ato <br /> LY <br />