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LLECTRICAL PERMIT AFRIC TION <br /> -. 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.gav/permits <br /> PROJECT SITE IINFORI I ATICIII-. <br /> PROJECT ADDRESS: 2.1 ICI C h 'estn u 1 St.f L=ve r i+ , q("l zo I <br /> BUILDING AREA(if residential,new construction,remodel,or addition)•CLPP1'C �i � S iVI& J for rt.] <br /> BUILDING TYPE: 0 SFR DETACHED 0 SFR-ATTACHED !Ia'6UPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: L A p I(`:X <br /> ELECTRICAL APPLICATION INIFORMATION <br /> CONTRACT PRICE OF WORK:$ EiDo <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? IIP(ES CI NO replace exIsf iV)0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable):' ,off <br /> DESCRIPTION OF WORK: e (1 Y" re lace ex 1 s 1 1{ I r( deviczs as <br /> needed d to ii1(1l rc > lis tits, HzO Rent cirri Iec-tric tiva(f <br /> hecfers , <br /> Ke ft-tCp, 1/1tss j C I tt breci keys -r- chesse aOaf p <br /> � 1� breccl' <br /> IG � o 4` cl <br /> 1wirr. <br /> - M <br /> ...... ,:: . ., ,. . O_,.. ...... T INFORMATION. :• <br /> : - <br /> OWNER NAME: PCU J 4-beCf V1 VKZ.cue I S C'r- TENANT NAMES. (If Commercial): N/A <br /> OWNER MAILING ADDRESS: STREET 2.3j S er I I VIC''•! o 1, yF,' J� <br /> CnY bled r© )Alco I I STATE in/A ZIP ciCJ2S-1 <br /> OWNER PHONE:Pat L 4 g Li'l I ` OWNER EMAIL: Peal I c5e3 I,Ore ClU f I C' k Q <br /> CONTRACTOR NAME: Owner J <br /> CONTRACTOR ADDRESS: STREET • <br /> CffY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: gOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42_6 a q CI i s 72-B5 <br /> Paw 1 SOISQr CONTACT EMAIL: au l 1 e fr or ou � � corn <br /> AGREEMENT::T herby 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 will be completed whether specified herein or not The granting of a permit does not presume to give authorityto 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 i <br /> comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE n <br /> 4311 <br /> PERMIT# <br /> t <br /> n 1'2a , '( c�, 3/2-11 i E l$D 1.g <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />