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"IIPIIIIIV‘/-"-A <br /> hLECTR1C L PE IT APKICATION <br /> ..iiiii ._ <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> _ .. . : <br /> : , . i-�^-.� .. PROJECT SITE rtiFORnn�T'oW° 1_W :6- , . . <br /> PROJECT ADDRESS: 3'311 1 k&J -L.-1 MO RL, '\v G EL1 7-T - F b 2.0 I \(A <br /> BUILDING AREA(if residential,new construction, remodel,or addition) Z,.25 6 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED DUPLEX 0 MULTI-FAMILY-#OF UNITS: `L. 0 COMMERCIAL <br /> N <br /> USE OF BUILDING: 12. 51 D TI I\ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ -ZOO <br /> NUMBER OF DEVICES(if low voltage):, C.O NI i i Fr <br /> FIRE ALARM? 0 YES ,12-NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): C. 1`4 0 5 - C>I- <br /> DESCRIPTION OF WORK: \CA 0 Lc. n t-7 21/2,11 Co (U 1 T <br /> • <br /> _. - .CONTACTINFORMATION. <br /> OWNER NAME: K1 Q5(`j'\1 tn ivrttS\-/ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: 1 2 <br /> STREET k iV\d , SA- 4 - 1.. Ti <br /> V<AR\Q fI:'1)\\ CRY V V A STATE 1 t1 1�L7-) ZIP <br /> J ' $Nas <br /> OWNER PHONE: �,.`Z2� �`—t ,. .OWNER EMAIL: ,. . . ..�� ,. , . . . !1�Cn�. ° .... .. ... .. <br /> CONTRACTOR NAME: r3 Cr6 (j kt 6 rZ <br /> CONTRACTOR ADDRESS: SWEET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ItOTHER(Please Specify) 5 U PV%'01Q.., <br /> • <br /> CONTACT NAME: - CONTACT PHONE: 4` c 0\222_, a 037._ 'j <br /> ` jt� / <br /> `-- l,-J\W 1T CONTACT EMAIL: W b �,,, f�1�'�oil).0& 5 0 L ( Ol..„(Om <br /> AGREEMENT:T hereby certify that I 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 authority to violate or cancel the provisions of any other state or <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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> . SO ,— <br /> PERMIT# <br /> t _________J ANJ . \ - ()- \ ..c -014'9 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />