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/IMP_ ,_. <br /> LECTRICAL PERMIT AAPPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-88571 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION. <br /> PROJECT ADDRESS: 2.4:20�� couay A‘,/ • <br /> '� <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 /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ . <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: c., ,CiOt L.— R7)/2-- N £/ R 4714 iliodYIS <br /> • <br /> CONTACT INFORMATION <br /> OWNER NAME: f%( kfL T €€TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ''?n 0" "'? �„�{cj�f. c (17E 1 Z .D <br /> CrrY ZI f STATE LA".4:11 ZIP 2:) <br /> OWNER PHONE: <br /> .42s- °"" ��Z.�.'' OWNER EMAIL: <br /> CONTRACTOR NAME: �^ � l �., � c,e <br /> CONTRACTOR ADDRESS: STREET r, 0 �L <br /> CITY e.._-4,e42 -1-7. STATE 1.1_14,. ZIP 5-ea, <br /> e,CO <br /> CONTRACTOR PHONE:VS.- 51 .- ? J CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): K. €C 3,-7/765- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): f <br /> dg— <br /> ..-.. ..�.n._, Nig <br /> K...,.,,x.,..w,...rn_....,>...�_. ...,.. W-.,..: ._.,.... <br /> PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONT <br /> A''��CTT NAME: ��, CONTACT PHONE: <br /> /42-A '� - c5& 1 � CONTACT EMAIL: <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 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 /> *g742/ie <br /> PERMIT# <br /> E Nog - ow <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />