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I 62.92 . 212q,O01 ( c i 7) .) <br /> ELECTRICAL PEWW\ IT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 1 (E)everetteps@everettwa_gov j www.everetiwa.govlpermifs <br /> I. _ <br /> ;,t:. ;f:. :Ir ^;1. 5;'9 'i; q' <br /> yi .y ,F_Aq�Slit; <br /> qp t_ery.,.q.��-Y_ \..r•.[�..] uj�7(;�: ••�' -•: „f:•• .t <br /> PROJECT ADDRESS: L07 3I a.. l4-1 /O <br /> BUILDING AREA.(if residential,new construction,remodel,or adn) SF <br /> BUILDING TYPE: ©SFRDETACHED ElSFRATTACHED El DUPLEX Ll MULTI-FAMILY-4OFUNITS: j4COMMERCIAL <br /> USE OF BUILDING: =of (,__.__Elfg <br /> •y r!i j� •m+..rt i-a1Ve(.[j.a •y4.aMy' vt,•t\• yrt-R_.. <br /> S.nb • <br /> J ;ft'•..-t.tey`�s c•:• i�.J..: y4.. rf'4el, � t c��1'i�U eft A ,�{iR��„'���'Alf'�[ .i. n.`:-'??� }:1': .�".—r'fi <br /> .... •.- � �V y' spy <br /> .. .,<..••._. •.c :r_.. •.._..: a et'1 [.[� .�,.jy�a p"���e!p�'��"r3�....y rx�.ner w aKln•..q[•nc+liY ...v-st�\� '...[. R:i i:1 �iy <br /> 1 OF WORK: <br /> .. 30F), Nr,' f. �,.+✓ .r... it• : o. 'Y[ •fr,t iti•t?�.�.' <br /> CONTRACT PR[C� AY Q.IZr�:.P <br /> NUMBER OF DEVICES(if low voltage):t <br /> FIRE ALARM? 0 YES Rj NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ti.,�° -i-r l. I \ ` kX1-•i 5 —4— 0 p ,L ( >zfo ,ik). <br /> 1` ` i&(Q_ .2 Li 00 V at Hca ( ._ ion , .:31 a n C l ' ..fit ri Vic( ) . _ <br /> V)d <br /> CL _.� -...,e. -f D 0C�VI'3ole.,.. .°_�kc.a `-' J <br /> Y ' <br /> . .._:•h n ':W.. .f,. .. r] - _.. ••. ,C01Stirr4.4 I•:*9104A.'T O0::. _ - '.' •:::2:1::::t• 5 <br /> OWNER NAII1lE: TENANT NAIIIIE(if Commercial): BC) //J(' <br /> OWNER MAILING ADDRESS: STREET p ,ADX 3707 . • <br /> cry EJ}'(7"L& , STATE 1A/(}- ZIPqg/2q 226 <br /> OWNER PHONE: OWNER EMAIL: <br /> ,•. . YI r. .ry 1r. r i+•-r µ •♦-r • • • Y } ]V G H••_j't Yr..;,- •. . I a• r.• , .._ [ . •. • ,. .`• a.,•,. [ • <br /> CONTRACTOR NAME: (. 1..)6r../7'L. �_57 liC�/04.-� _ <br /> CONTRACTOR ADDRESS: amserj yI���Gg Box <br /> ��4/e /� <br /> CITY ,17,19.-•J !L.-� SrAlTr�4 ZIP 2,0 <br /> CONTRACTOR PHONE:426-214-6144 CONTRACTOR EMAIL: ki-jej, H.f,im E-gtp kl'wi rt (DIS <br /> CONTRACTOR LIC.l(REQUIRED): a•Aic 4/1 Q Z ,CITY OF EVERETT 5USINESS LIC.#(REQUIRED):O4C159 <br /> PRIMARY CONTACT: Il OWNER BI CONTRACTOR 9 OTHER(Please Specify) • <br /> CONTACT NAME: CONTACT PHONE: 2 -736-654.4„ <br /> . D'JJ 1ki 1 5 6,e01/1/ CONTACT EMAIL: DEN Al i ,(tt DW a kiMi/I T, &o/Y <br /> AGREEMENT:T hereby certify that'have read and examined this application and know the same to be true and correct Allprovisions oflaws and ordinances governing this <br /> we of work willbecompleted whetherspecfliedherein rrnot. The granting of a permit does not presume to give auhiorityfo v!olate or cancel time provisions of any otherstate o/ <br /> local law regulating consinictlon or the performance of construction. That!am authorized bythe ownerof this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.2TRCWand 29e2OdWAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT!? 2 <br /> — Cici . <br /> • , <br /> pwrieuir/A,'rued <br /> A. Signature` Date (Revised 10/12l2016) <br />