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09,i2712016 08:36 #1011 P.001f001 <br />�' � <br />�;,���� <br />�LECTRICAL PERMIY APP�ICATION <br />' C17Y OF EVERETT PERMIT SERVIC�S <br />!':` 32�0 C�DAR STR�ET, EVERETT, WA 98201 <br />,�. <br />(P) 42�-257-8810 � FAX 4�5-257-8857 �(E) ev�retieps�everettwa.gov � www.everettwa.gov/permits <br />III�.: . <br />p, <br />s, � , � c� �,` , � ',;�r ;���7,Q�:�,Cr�k.�►,'�;TF.r,�i1i,�Q��:�i�%�.�":'�r ,' ,._� � � <br />.,, �. ,. �..� ,�.:�:. a,. �,.,.... �.. <br />PRaJECT ADDR�SS: "f �� S f,�J ,����� f� /f�(.If�G+L ��J' <br />BlJII.�ING AR�A {if re6ldentf�l, new construction, remodel, or addition) _SF <br />BUILDING TYPE: ❑ SFR-D�7ACH�P Cl SFR-A77ACHED Q PUP�EX ❑ MULTI-FAMI�Y -# O� UN1T <br />��: <br />us� oF aui�piN�: �'.i�iC4�tM LGt.C/� <br />cor�rRaCT �Rlc� oF woRK: <br />NUMBER OF DEVIC�S (if°low v <br />Ir <br />FIR� ALARM? ❑ 1!�S <br />ASSOCIATED BUII�DING�'PERR <br />pESCR1P7iON OF WORK"; <br />co <br />NAME: �/((JJ <br />IVIAILING AppR�S! <br />PWQN�: YL,�__ � <br />CTOR NAME: <br />CTOR ADDRES3; : <br />ca <br />� <br />�� ,�uter�-� <br />� �It.�Z� OWNER EMAI�: <br />fi f.��! � S� <br />srR��r � � �OIC' l��'1 <br />r <br />camm <br />STATE <br />❑ COMM�RCIA� <br />,. <br />�- �v <br />CDNTRAC70R PHON�: y CONTRAC7�R EMAII.: <br />CONTRACT�R LIC. #(R�QUj�RED); l� CtTY OF �V�RETT BU5lN�SS LIC. #(R�QU1REn�� 43`Q <br />PRIMARY CONTACT: ❑ QWNER l� CONTRACTOR ❑ OTHER {please Specify) � <br />CONTACT NAME: I' CON7AC7 PHONE: � � ��l <br />L,J � ,.%�,�ii CONTACT EMAIL: <br />AGREEMENT: 7 hereby ca�tify tha�;% heve read 2nU Axaminetl tA/s 8pp1lCatfon and knoW the sams to bs frue and cOmott. A!! proVlslone of(aWs and ard/nances govoming lhis <br />rype of work wi/l be completetl wAej�er specifled hereln arnoL Ths pranting of a pe�m/t Coes not presume to give authority to violate or cancel fne provrsrons of any othor srete o� <br />/ocal law �equlafing construcEion or•the performaxe olcanstrr�cthn, That I am authorized 6y thm awne� af tnis properry to peNorm tha work ro� whicn a pp!lcatron !s mede an4 I <br />comp(y with the State Contracto� L'�w iB,27 RCW a�C 288,204 WA� <br />�� Clty of Evereft Official Usp Only <br />'.'�: F�� <br />;;: <br />, �7 ��� <br />PERMt7 # <br />� `�V�r�� <br />(Revlsed 1P/12120�5) <br />