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J !ELECTRIICALo • C TION �C11110� Q�� Q 'RYE rETT CITY OF EVERETT PERMIT SERVICES `-___, 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJgC u S II`�'E III FO::GP , 1�1'IION PROJECT ADDRESS: .. 2'77/ iiut✓I� . ,/\� , t/ R___ nC� ✓ ®wi-� �✓� ��2�1 BUILDING AREA(if residential, new construction, remodel,or addition) /�.-t-,�i(�/in I i SF BUILDING TYPE: ISFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: D COMMERCIAL USE OF BUILDING: PL- e-U/ �-5/,2r,ca— ELECT6 IICAL A'PPLIICATUOM IIV IIF toRiV1ATllvi CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage):_ 'FIRE ALARM? ❑YES I�NO / J ASSOCIATED BUILDING PERMIT#(if applicable): L2 / �f. O�7� /� JJ ;DESCRIPTION OF WORK: /h 5t C� 7/://�c i ;5, /ti gh/// u/1�r c/'A C',' , ,„ n /� v; tj ail 44- ..tom✓,___5 „ter L-i AA/'try- al ti-2- a✓ / a//7 Q- a c.r� 1?9, t t-GI NI v/E S /h� l�cxr/ v � CClJvl 5 � , __ _ ?-- -e-ted2- ---/ kSO(A ---0 (--(,. CONTACT IINFORI 1AT>IO\! OWNER NAME:j<:- 5-- ,21 2 --1 J // TENANT NAME(If Commercial): ---- OWNER MAILING ADDRESS: STREET "2- /�'j//14'55 c5c-5� a�t' 14741 /(//J CfY L=�/LL✓L/' STATE 1// " _ZIP J 4 OWNER PHONE:L`Z5- / o.I 9 -/ OWNER EMAIL: ,,,, ...-_,.,,,,_.,,/,,,,„_, CONTRACTOR NAME: CV e__SSF SrJ ow lr1 '\du ,.. \ eiNN ti CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: • CONTACT EMAIL: AGREEMENT.-T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this 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 local law regulating construction or the performance of construction. That l am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Ev 0 cial Use Only FEE PERMIT#G r - o3L( rner/".... ..----,, 5'Xi)/1-e-/7 E r /Authorized Agent Signature Date (Revised 10/12/2015)