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gfLEGTRICAL PERMIT Of PLICATION <br />CITY OF EVERETT PERMI�J RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 FAX 425-257-8857 ] (E) everefteps@everettwa.gov I www.evereitwa.govlpermits <br />j� �j �i. (�]� r�`-39IIp8 Y'S .K'-i :; (...•- :iI-s.+.•-.:- <br />-.'.e.L Awn f;• .:'�-1'.. :i.-:Y::ti: '--•. -_ - - <br />r• <br />PROJECT ADDRESS: (.. -- 3 �_ ► v. <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: El SFR DETACHED Ci SFR ATTACHED E( DUPLEX. EI MULTI -FAMILY - # OF UNITS: COMMERCIAL <br />USE OF BUILDING:e FLe. <br />sT,;�;� fir..=:�-.. :,,••• -, = h,.r.�auoa- � _ - ,�g — - ••.w:s, - <br />e�e�3 t. _ ':�vtes:�a:t•a;•:?aw,��rs.« _ -.z:�::v:a�.a.::.�s:a.�a•..:=::5. .sa. ,c <br />CONTRACT PRICE OF WORK.- $ O t 6 0 <br />NUMBER OF DEVICES (if low voltage)- <br />FIRE ALARM? ❑ YES LXNO <br />ASSOCIATED BUILDING PERMIT # Cif applicable): <br />DESCRIPTION -OF WORK: 1.,,_ 5 �'4 (� rJ u� rr a I� k w-� �—a Le 1 runt-- <br />1-- _ - - - - .. t = - �COI+i`1':1�;CT� Il(�>�0�. ro Tl©1(�1=� - --- . - - •• -_ _ - _- --- <br />_ <br />03NIdi=F TIAM 'i• (� 7� 2 I vim- _ ' TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTREET <br />OC> t ✓,•-d <br />? CITY <br />3'Ci j SiA7E ZIP <br />OWNER PHONE, <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET <br />COY <br />1 317 St <br />STATE zip Qsr <br />CONTRACTOR PHONE: <br />CONTRACTOR LIC. #(REQUIRED)• <br />I —(aa61 CONTRACTOR EMAIL: <br />(� "i S CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 6 4 <br />_� <br />PRIMARY CONTACT: EI OWNER JaCONTRACTOR El OTHER (Please Specify) <br />CONTACT NAME: <br />® i .. C_- f r d n <br />CONTACT PHONE: 6 <br />CONTACT EMAIL: <br />AGREEMENT- Thereby certify that I have read and examined this appllcaifon 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 ornot. The granting of a permit does notpresume to give authority to violate or cancel fhe provisions of any otherstate or <br />local law regulating construction orthe performance of construction. That am authorized bythe owner of this propertylo perform the workforwhich application is made and I <br />complywith the State Contractors Law 18.27RCWand 296200 WAC <br />City of Everett Official Use Only <br />FEE � <br />I <br />PERMIT # <br />5ignaf1re Date . (Revised 1011212015) <br />