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illtECTRICAL PERMIT AIIILICATION <br /> 14Y;- e 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.govlpermits <br /> PROJECT SITE INFORMATION.. <br /> PROJECT ADDRESS: 01 - trEWITT <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ULTI-FAMILY-#OF UNITS:r� crA El COMMERCIAL <br /> USE OF BUILDING: I I ��ik/k� � <br /> • ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ `7gi7� ( V Q <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �-C �U > CX,) N, U A' 1'r U MI <br /> .70,-,agir-3.1.34.,,,,r. (02, <br /> lout_ N'eC-- <br /> CONTACTINFORMATION <br /> OWNER NAME: r�e W > 71- S. A-SS(#2 <br /> OWNER MAILING ADDRESS: STREET )- I t ( CAA-VC-WAIN\PS 8r Cj <br /> cir( STATE1 V/Pc ZIP 1��v 1 <br /> OWNER PHONE:�2—cc 4O y" 01,E (OWNER EMAIL: I�G1 V SV IJ I 14 I rr CQiwt 1.•t0014 <br /> CONTRACTOR NAME: 11 l Y`� f A`i�' <br /> CONTRACTOR ADDRESS: STREET �J I .5i /1 v V SF- <br /> Cm( STATE 1PA ZIP L/a <br /> CONTRACTOR PHONE: —3 I1 'C70 LI) CONTRACTOR� 1/ � n EMAIL:APAIVii) P ADC GLA 1) t <br /> CONTRACTOR LIC.#(REQUIRED): IF A (�Vi"I tJ 'K 1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):OLP)31i+ <br /> PRIMARY CONTACT: 0 OWNER !.` ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: ,�, .(f CONTACT PHONE: . � � <br /> K 1 { , Q/1�1 vV CONTACT EMAIL: , . ,(4 /Wo COM <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct All 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 /> E 11 $13-1(92-4 <br /> 4/Th- <br />