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ELECTRI l� PERMIT CITY OF EVERETT PERMIZ JrPLICATION RVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 [ FAX 425-257-8857 ] (E) everetteps@everettwa.gov[ www.everettwa.gov/permits [BUILDING �sECT ADDRESS:DING AREA(if residential, new construction,remodel, or addition) SF TYPE: C1 SFR-DETACHED IZSFRATTACHED L7 DUPLEX ❑MULT1-FAMILY-#OF UNITS: EI COMMERCIAL OF BUILDING: Vkn _ .41 V A ppfpµ��r. i-T�®I�•L A _ - pQ gry�p ti:�q_n�y ��yyp �lla�•-•Ili p�1 lLd� A Ir t• CONTRACT PRICE OF WORK:$ a�O NUMBER OF DEVICES (if low voltage). FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): � , f DESCRIPTION-OF WORK: �Il� y JT'/e{ys ilk, I 1 . :-. - NTACT�:II�iFDRflt1AT10N`.: FCOO)WNER TENANT NAME(If Commercial): MAILING ADDRESS: STREET r iA- CfiY STATE 1/ V� ZIP D OWNER PHONE: S- f J 0 3' 7 O � OWNER EMAIL: CONTRACTOR NAME: (, !oUIilio? M CONTRACTOR ADDRESS: STREET /�1 CITY f / STATE ZIP CONTRACTOR PHONE: - CONTRACTOR EMAIL: CONTRACTOR LI77 C,#(REQUIRED) �- j�/ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(� PRIMARY CONTACT. ❑'OWNER �4ACONTRACTOR� EI OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: o 06 c f ,5 Gi —7 CONTACT EMAIL: rk/f AGREEMENT.•Thereby certify that ave read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein ornoi: The granting of a permif does notpresume to give authority to violate or cancel the provisions of any otherstafe or locallaw regulafing construction orthe performance of construction. That I am authorized by the ownerof this property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27RCW and 296 200 WAC. City ofEvereff Official Use Only FEE PERMIT# ner1Aut6 tze entSignature Date (Revised 90/12/2095)