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_�LEGTRICAL PERNT jrPLICATION <br /> CITY OF EVERETT PERM] REVCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425.257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> -- . - _ <br /> <� T <br /> �1( I <br /> ahl� -- - <br /> [13 <br /> OJECTADDRESS;LDING AREA(if residential,new construction,remodel,or addition) SF <br /> LDING TYPE: CI SFR DETACHED ClSFRATTACHED EIDUPLEX MULTI-FAMILY-#OF UNITS,. CI COMMERCIAL <br /> OF BUILDING: <br /> YVId*�' - - <br /> _ (figg� ,}ro!�(,� �a.pp pll=�l4q-�6v4W �..t?•..r:i:.::':=i'.< <br /> L��11i'A Ey�AirlP�l--i:&^ll - - •t: :.d� �.:.::�? <br /> CONTRACT PRICE OF WORK.;);.r 1c)01 <br /> NUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? ❑YES I7 NO <br /> ASSOCIATED BUILDING PERMIT#Cif applicable)_ <br /> DESCRIPTION-OF WORK: <br /> ` SCA <br /> CO TACT)<ialFOR[VIi4TiON <br /> QINNER NAME ': TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET �1 �— <br /> \��j f <br /> C 7Y� D�L : STATE ZIP <br /> OWNER PHONE: � � _ `^V+ >� OWNER EMAIL; <br /> CONTRACTOR NAME: V➢ Y`UVJ zW <br /> CONTRACTOR ADDRESS: STREET C` O <br /> P <br /> CITY \ ovv_ STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC,#(REQUIRED);m , _ � l CITY OF EVERETT BUSINESS LIG.#(REQUIRED); <br /> PRIMARY CONTACT; Q OWNER CONTRACTOR 1=]OTHER(Please Specify) <br /> CONTACT NAME: r CONTAGT PHONE: i s <br /> , Vt. CONTAGT EMAIL: <br /> AGREEMENT.'T hereby certify that I have read and examined this appricailon and know the same to be true and correct. All provisions of laws and ordinances goveming this <br /> type of work will be completed whether speclTied herein ornot. The granting of a permit does notpresume to give authorify to violate or cancel the provisions of any other state or <br /> locallawregulafing construction orthe performance of construction. That t am authorized bythe owner of this propertyto perform the work forwhich application ismade and I <br /> comply with the State Contractors Law 18.27 RCWand 295.200 WAC. <br /> City ofEveretf Official Use Only <br /> FEE �l <br /> PERMIT# <br /> Ouvner/Authoriz' _A .entSignature•. Date (Revised 10/12/2095) <br />