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PLECTRICAL PERMIT AP1hCATION <br /> I�►� - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SIT.E,INFO.RMATION ,,. <br /> PROJECT ADDRESS: 7JJ CZ,. Ot tj..- <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ? COMMERCIAL <br /> USE OF BUILDING: \ <br /> ELECT T1 IC 1L APPLICATIO±1 NFORMATIO1 ,:. p .. . . _ .. <br /> CONTRACT PRICE OF WORK: $ /00 - <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> [pQth •W 7 Z/0 �i° g).Z' <br /> :CONTACT INFORMATION <br /> OWNER NAME;J( !Jai u i TENANT NAME(If Commercial)//) y nit" i1 <br /> OWNER MAILING ADDRESS: STREET 4570 0 $::, f_vo . L <br /> L - C%X <br /> CITY "t/1"-4/Lej°1-- t4)\4 l 1 C Cfg7gTE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 94 7'L/eS C 47. - I,4" l <br /> CONTRACTOR ADDRESS: STREET I(O �• Z.. Pe <br /> CITTYi/ 4-4V-4- STATE j4 ZIP l'e .)-3 <br /> CONTRACTOR PHONE. l r7 4' ".5.7‹.,f NTRACTOR EMAIL 4J )S e--A,4 ell <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER itik2NTRACTOR 0 OTHER(Please Specif�y))� <br /> CONTACT NAME: ` CONTACT PHONE: it e:ci� /-XdO eg3 <br /> 1110) S €) CONTACT EMAIL--twj,,.e „ g��i4,ti <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions f lawJ'and orl� ces 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 <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 /> PERMIT# <br /> I 7 k E 1 . 11- 137 <br /> O er/Authorized Agent Signature Date (Revised 10/12/2015) <br />