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ELECTRICAL PERMUITWPLICAMN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98209 <br /> (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.govlpermits <br /> PRWEC➢' SIITG QMFORil4��aiT➢�G 1' <br /> PROJECT ADDRESS: V <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: RICOMMERCIAL <br /> USE OF BUILDING: <br /> • <br /> LCEQT�I AL; .. PI QC SII ROM ➢1�9IF©�1�4iA5f Q0R9 <br /> CONTRACT PRICE OF WORK- /Z/ Ol?: 0,1 <br /> NUMBER OF DEVICES (if low oitage):- <br /> FIRE ALARM? ❑YES 1�1 NO <br /> ASSOCIATED BUILDING PERMIT#1`(if applicable): <br /> DESCRIPTION OF WORK: sN*if 3' AJtt,J I z J c '�'�U' ."5 <br /> �f i Gf wt <br /> S '+ <br /> (C®R9`H`ACT ➢NIFORPAAT➢®9@g <br /> OVVNER NAME: �V1 fti jc�(pCY_ IST, Z TENANT NAME(if Comm ercial): G'_c ia- <br /> OWNER MAILING ADDRESS: STREET 7 ✓ 7 2 <br /> crrY VPO e# STATE ��r ZIP ��Z6 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: '��?. "F'i't' c—`..._t. e< CI l..Pes,� <br /> CONTRACTOR ADDRESS: STREET �c.Z� Edi�` 7 <br /> CITY ZAK. 312917--A STATE (- 1G ZIP t�. <br /> CONTRACTOR PHONE: 36,0 :+r 00// CONTRACTOR EMAIL: =s/fC /� ° 1�L�1 r'►� `i 6 <br /> CONTRACTOR LIC.#(REQUIRED)• t3�.VlC 4' C`tiS�S^Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED. +C("j <br /> PRIMARY CONTACT: ❑OWNER w. V9 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTAggGT,,NAME: CONTACT PHONE:t)c <br /> 5 .f1,.� CONTACT EMAIL• <br /> AGREEMENT Thereby certify that/have read and examined this application and know the same to be true and correct All provislons oflaws an 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 am authorized by the owner ofthfs property to perforin the work for which application is made and/ <br /> comply with the State Contractors Law 18.27 RCW and 296 200 WAC <br /> City ofEverett Official Use Only <br /> FEE <br /> PERMIT# <br /> E 1 -�Oq- <br /> Owner/Authorize ntSignature Date (Revised 10/12/2015) <br />