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&LECTRICAL PERMIT 4PLICATI®N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov WWW.everettwa.gov1permits Rim A PROJECT ADDRESS: BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE. 0 SFR-DETACHED 0 SFRATTACHEDF1 DUPLEX [I MULTI-FAMILY-#OF UNITS: El COMMERCIAL E S. U 'a OF BUILDING: INIF R APPLI ELE CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES (if low Vol FIRE ALARM? u YES Er-N'o ASSOCIATED BUILDING PERMIT applicable): DESCRIPTION-OF WORK: .9.t� gt�'HD 6"J -CT-;Q_1Y,_1RRMAT Ek NAME;: Commercial): NAME(if Comercial): FrOWNER MAILING ADDRESS: STREET .?, T CITY STATE ZIP OWNER PHONE: =OWNER EMAIL: CONTRACTOR NAME: Gozelej �_ CONTRACTOR ADDRESS: STREET q CITY f�A S�i Zip CONTRACTOR PHONE: 419_5--qA3 -<3735? - CONTRACTOR EMAIL: Litk, Co,�-i CONTRACTOR LIG.#(REQUIRED): clzw.-- CITY OF EVERETT BUSINESS LIG.#(REQU1RED);!;�M_)L. PRIMARY CONTACT: El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: GONTAGTPHONE: CONTACT EMAIL: - AGREEMENT.'T hereby certify that I have read and examined this appricaflon and know the same to be true and correct. All provisions of laws and ordinances governing this type of work WX be completed whetherspecified herein ornot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or locallawregulating construction orthoperformance ofconstruction. That I am authorized by the owner of this property to perform the work far which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# (Revised 1011212015) ovw,vn.L m.JAS.6'51 4S!g�h�e Date