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LECTRICAL PERMllT �LIICATION <br />1 V <br />CITY OF EVERETT PERMICES <br />32-00 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-•257-8810 j FAX 425--257-8857 ] (E) everetteps@everetwa.gov 1 www.evereiiwa-goWpermits <br />�)I C4� <br />��'-ill• _I�'=�.`;.:.��" <br />.li. Fin .3i,-.C.�:! �:4_q?_ ;...,:%Y:',.,i'=:=l=i:.•+. _ <br />PROJECT ADDRESS: l.,( (� <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: El SFR-•DETACHED 13 SFR ATTACHED I1 DUPLEX n MULTI -FAMILY - # OF UNITS: COMMERCIAL. <br />USE OF BUILDING: AV r w ,N <br />sf'+`�-- , ;�_`'- _ _ _ ae::< < <�...-.:,�r.:u<a:,q=a_.pm:p�� � _p �g�„ � n_fi� _ _ y_� _7� —_g_� p__�q _gyp � _ - ••.�k tici t `1 <br />';v rr�1�11a1�� �i.a-`�t:.-.�.2'is_.^...�.>'-.'.4.:.S:C..ti..t}v.R:Y! �i.s�:..it'r; :•.K'�� _ <br />, [• -_ .. ,.tea.=e�.>T.e >,�'�,h.��Sd__:� <br />CONTRACT PRICE OF WORK: $ 0 o <br />NUMBER OF DEVICES (if low voltage)' <br />FIRE ALARM? ❑ YES NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION•Ol WORK:_ S, s <br />LOA <br />- _ - - .. �CO--• `TACT 1[i�IF�O�� �TI©hl �:' ._ . - . .• -_ , - _ - _- - --_ _ .f. <br />Q7NNER NAME: ' a TENANT NAME (If Commercial) - <br />OWNER MAILING ADDRESS: STREET 3 0.� <br />✓� <br />r - <br />CITY <br />STATE ZIP <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />l <br />CONTRACTOR ADDRESS: <br />STREETZf- 1 <br />C17Y W1,o <br />STATE 1..jA ZIP 'i G r <br />CONTRACTOR PHONE: <br />l — 00 <br />CONTRACTDR EMAIL: <br />CONTRACTOR LIC, #(REQUIRED)• <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 6 t-1 a G tf <br />PRIMARY CONTACT: ❑ OWNER <br />ACONTRACTORR <br />0 OTHER (Please Specify) <br />CONTACT NAME: <br />i2r . z c _, I f A— I _ _ <br />ONTACT PHONE: (> o. <br />FCONTACTEMAIL:-- <br />AGREEMENT- Thereby cent Ty that l have read and examined this apprrcal on 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 speelfied herein ornot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br />locallawregulating construction orthe peuformance of construction. That am authorized bythe owner of this propertyto perform the workforwhich application ismade and 1 <br />complywith the State Contractors Law 18.27RCWand 296.200 WAC. <br />City ofEveretf Official Use Only <br />FEE <br />PERMIT# <br />Dvvner Authorized Agent Signature Date (Revised 1011212015) <br />