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OLT ELECTRICAL PERMIT AF ! 1_ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: yt 2. 7 L/ 'f/- 5i S <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: .(S COMMERCIAL <br /> USE OF BUILDING: (il�a$7' tt/e i-'/`C6^ (v .c(�T/ya r- ,,/et A* 4,Jh,/t. f7/'e--/e-t, e./ -/ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 20, o G 4 <br /> NUMBER OF DEVICES (if low voltage): /(5- ILO 6 C rl/'G4i TS, <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: /1/)prak /5- �a i2 G. /2c /a6 !/A <br /> CC <br /> lir' / FrOrn SI 4rc /�( i //anti/X JO /th ew Einrer5 - /3a cA <br /> /21 w c 4 h�-C t. / C / O' <br /> C r �"G k r'JJ c !r' /Cc A e h�. ` CO n -.r LLh/ C-r4�d7 j crh-/ of 1-To e C G <br /> S t/ 5-1,4 N+ �% Z A r•r f r` F' !t� .f F - (7 c /37 <br /> S` <br /> / CONTACT INFORMATION <br /> OWNER NAME: C, f O r TENANT NAME(If Commercial): E(j PC F <br /> OWNER MAILING ADDRSS: STREET 'Jo o 2. {,(/cCT�jnr� ,4 1/E< <br /> CITY Eve k„G STATE WA. ZIP 9,42210 <br /> OWNER PHONE: 4/,,,2,7"- 2 7 - ,`SJ-a 2 o OWNER EMAIL: <br /> CONTRACTOR NAME: C . 7`y o /v4C r c /74 — ate/, (t!/` <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: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: /t r 6 �Ji CONTACT PHONE: f/ .5-.1_ 57_ ),7,,23� � <br /> CONTACT EMAIL: Ai C f/kis 7. a EG'rrr /7c/ 6,06, <br /> AGREEMENT:I 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 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> AtiZti/ a.,..„,y„ /07„/„,„_. Emo- <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />