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ILECTXIICAL PE MIT O' PLICATION <br /> fCITY OF EVERETT PERMIT SERVICES <br /> .� -�� rr�rr <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> - <br /> . - . . i <br /> PROJECT ADDRESS: / Z Z- . r' 5 - <br /> BUILDING AREA(if residential,new construction,remodel,or addition) /n-)L7 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> !USE OF BUILDING: ,/N► <br /> • 0,000.10-4 APFiICA`I'1®N <br /> CONTRACT PRICE OF WORK:$ -7/ OCA <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 3 'ES ❑NO <br /> ASSOCIATED BUILDING PERMIT#Of applicable): <br /> DESCRIPTION OF WORK: /�1d f,��yJ,161 I Ai f4 / 3 mut food, <br /> ;..:_:ON. A„.T:INF®RMATI®N.. <br /> OWNER NAME: 5-'f ,A 1( TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sraeEr 9f e6, 2`' P( j t <br /> cnn Cve rM STATE td- ZIP 1 v 20? <br /> OWNER PHONE: gel% C ! - /7 OWNER EMAIL: .SP E' c: 6611-1 <br /> CONTRACTOR NAME: 14/5°7 vic"c Ve,c_ <br /> N <br /> CONTRACTOR ADDRESS: STREET /7 .-29 7 z G'`✓ J/�- �i0? (set <br /> CIN ( v) STATE IAA f ZIP 70O <br /> CONTRACTOR PHONE: 91-5”. 5 __Ycif, CONTRACTOR EMAIL: ta4 I I2 e F c. C.c0» <br /> CONTRACTOR LIC.#(REQUIRED): 11401/....5S E. ,7 .#(R D):b� /3 <br /> �q �/ CITY OF EVERETT BUSINESS LIC EQUfRE <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ETHER(Please Specify) act•fr)c.t'1 <br /> CONTACT NAME: CONTACT PHONE: �f 3 , , /y 3y <br /> 5° CONTACT EMAIL: ��` / ;✓E', �D <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to.8-etrue 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 authority to 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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 150°° <br /> .-� - PERMIT# <br /> Owner/Authorized :s- t Signature Date (Revised 10/12/2015) <br />