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04.17 'ELECTRICAL PERMIT �, LIGATION <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 /> PROJECT SITE INFORMATION, <br /> PROJECT ADDRESS: yZ/ hey-/ wig <br /> BUILDING AREA(if residential,new construction,remodel, or addition) /7,04 SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: Zz, /, /T L <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: jls-re pAes' /na a< /f1/ <br /> AAC11.1 Gl//124r-1 /moo X ES 5Gv 'fl key" L� Li, 3 <br /> CONTACT-INFORMATION .: . <br /> OWNER NAME:/,vz 4 f/ /JG</2.2/s" TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ��9 z 9 �± <br /> eITY G///V Z '/ STATE /�"' ZIP fir 20/ <br /> OWNER PHONE: ZS -2/D - Pam/ OWNER EMAIL: ,.�,A'K/l,q/4 4 L/ - ' - CO.K <br /> CONTRACTOR NAME: 0!1/A/Ge <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: E WNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: -2/y — .5-8"/ <br /> 7 y4 `/, �'�S CONTACT EMAIL: A_Eyi2A/Gf/F`Fa C. BOG, cp,K. <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 /> PERMIT# <br /> � � 30 wiz E 788 ?4 g <br /> Owner/Authorized Agent i natre u ate (Revised 10/12/2015)g <br />