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477 CTRICAL PERMIT APRICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT `S/ITE INFORMATIONA <br /> PROJECT ADDRESS:3-3 t1 W GTMD►Z.0 V � L T ` g 201 /EuiLN 'vG .. <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 22`� v SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHEDUPLEX 0 MULTI-FAMILY-#OF UNITS: D COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ C7ujo /t <br /> NUMBER OF DEVICES (if low voltage): t LOW Ut <br /> FIRE ALARM? derfES ❑ NO sMOV-E pgreZT0 a-9 PC Z RAIN <br /> ASSOCIATED BUILDING PERMIT# (if applicable): I'(OS -C% k-t Ba(,-. -t. <br /> DESCRIPTION OF WORK: j 1.15TVk-1 J 1 LO i' u k J Ki C20(2_ 7C - `7Z <br /> 9-z,‘ - fSI LT i C A L � � 7�125 - 2 11't`) 2- AT r✓� 7C12` <br /> '0 -Y wNsffazS-- to \IeNT\ (j ¶AHS <br /> CONTACT INFORMATION <br /> OWNER NAME: O .'Si JVT N\JJLe4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET \U c'( 2{vtd, Sfi, -) 3I <br /> <A lA`' N lif CITY \A;A STATE ZIP °(8 U 3n <br /> OWNER PHONE: `2-06 '2-227 el, 6�i`T OWNER EMAIL: 6 tiO A'T cv' \ <br /> CONTRACTOR NAME: ? OWN <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: t !, OWNER 0 CONTRACTOR NiOTHER(Please Specify) suf-)R V l5012.,_ <br /> CONTACT <br /> l I NAME: CONTACT PHONE:42j az uo <br /> /1- ACONTACT EMAIL: Lk.m N-1-ht-,\ :3/�\4 <br /> ( AA_ CAA <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 type <br /> 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 WA C. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> , CYS--s — ZOE) E q $off - ' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />