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• • <br /> ELECTRICAL PERNIII T APPUCA1aON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-267.8810 J FAX 425-257-8857 J (E)everetteps@everettwa.gov j www.everettwa.gov/permits <br /> 112,' JECT 50TEE IliV10:0''MA IO <br /> PROJECT ADDRESS: 4 f, 1"` ICI° +' `tip IT (0 .} ;!, , fi 2_ <br /> ;BUILDING AREA(if residential,now construction,remodol,or addition) ,SF <br /> BUILDING TYPE: ©SFR-DETACHED Q SFR-ATTACHED d DUPLEX ©MULTI-FAMILY-#OF UNITS: '`,COMMERCIAL <br /> USE OF BUILDING: • <br /> EILEC'ar ROCAL APIN [C, IIOftL9 11M OR MIAT IION <br /> CONTRACT PRICE OF WORK:$ "'j,, I61 <br /> - <br /> NUMBER OF DEVICES(If low voltage): __- <br /> FIRE ALARM? ©YES ❑NO <br /> ASSOCIATED BUILDING PERMIT f#(if applIcable): <br /> DESCRIPTION OF WORK: (f,VVIC:003(, OA* Cl., (-t-h <br /> • <br /> _.. ..., ._. ......_ ..._...,_.. ..... ... �, ...:m- Y.-... ...._... <br /> . CONTACT INFORMAThotd <br /> OWNER NAME: J(,c (: ,44 sf et T e/ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CCONTRACTOR NAME: (1 e. ir-- C SET ap Heart- <br /> CONTRACTOR ADIDRESS: sisZcer 2I2© 1 _ • <br /> CITY - STATE: Z,IP(O ec <br /> ;CONTRACTOR PHONE(;2,0 `S 1_3tiLl CONTRACTOR EMAIL: <br /> �— [CITY OF ERETT BUSINESS LiC.#(REQUD):IRE Yc <br /> r C©NTRACTOR LIE.II REQUIRED � G VE ' ES <br /> ram: ? �7` I <br /> ;PRIMARY CONTACT: Cyl OWNER 1CONTRACTOR 0 OTHER(Please Specify) ____ <br /> CONTACT NAME: CONTACT PHONE: k.f 2.52..r�� — <br /> 1`-C�( L—L) CONTACT EMAIL: ��G?r� cP ,511,1 44-f 1'y(� <br /> AGREEMENT.I hereby certify that 1 have read end examined this application and know the same lobe true and correct. Ail provisions of laws and ordinances governing this type <br /> of work will be completed whelherspecriled herein or not The granting of a permit does not presume to give authority to violate orcancel the provisions of any other state or <br /> local aw 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 Lew fat%ROW and 296,200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT It <br /> Ow I./Authorized Agent Signature Data (Revised 9123/2016) <br />