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Sep 19 16 10:18a Roiy Villa . �60-653-4544 p.1 <br />ELECTRICAL PERM�T APP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320U GEDAR STREET, EVERETT, WA 98209 <br />(P) 42�-257-8810 � FAX 42�25i-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PR�J�GT SITE :IN�ORMATI�N <br />�JECT ADDRESS: I L'IO Z � fP � i1l_Y'�_�Q %! wa't'I l__�'P�Y^CJ7� I% <br />ILOlNG �1REA {if residential, new construction, remodel, w addition) SF <br />fLDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLDC ❑ MULTI-FAMILY- # OF UI�tITS: <br />E OF BUILDING: ,o �,-' ;` `' . t ar-� <br />ELECTRI�Ai APPLICATldN 1WFORMATION <br />CaNTRACT PR�CE OF WORK: S j'f�� � <br />NUMBER QF DEVICES (if fow voltage)• /�' <br />FIRE ALARN!? ❑ 1'ES NO <br />ASSOGIATED BUILDING PERMtT #{ff a llcable): <br />DESCRIPTIQN OF WORK: _/ S VDi C�. `�. '_(�, �Q d u �}--S <br />IWNERNAME: �� � .c ,/ i (ps <br />n►YNER MRfUNG A�DRES3: s�rnEFr <br />crnr � <br />IWpTER P1iONE• <br />;OIiTRACTOR N<tME; �� � • n P1 <br />ONTRACTOR AdDRESS: s1x�r <br />c1'n' / <br />ONTRACTOR PHONE: ►Lt7Wl� `� <br />ONTRACTOR LJC RE <br />CONTACT 1NFORMATION <br />�.� � <br />' - -- . TENANT NAME (tf C� <br />�P �v�r�ff- �11 <br />► <br />OWNER EMAIL: <br />�,�� i � f �'� <br />- / ���= �^f' �.�_ <br />V 1 ! IP_ <br />I[_narQer-rno �u,��� , lDr, � _ <br />� � S� . <br />COMME�2CiAL <br />mercial}: t'f��� .i n.� � LQ S <br />� T� � v�_�r � <br />sr�� �/(�� nc <br />STATE (/(/� �p <br />..ii � . . <br />- - �{ quIRE�) �7,� L� GRY QF EVEt�TT B�ISINESS UC. �(RE4UI �D : � ~ � <br />PRIMARY CQNTACT: ❑ OWNER i� CO{�tTRACTOR � OTHER (�iease Specify) , s <br />CONTACT NAME: CONT14CT PNONE: S- �p-� �I' !� <br />1 L � k� l <br />V` V I I CONTACT FJIRAIL: �� �� <br />AGREEM�IJT.• T herzby certily [hat ! hatne raad and axamined this application and larow tl�e same to be fi'ua and rnrrcct. A/l ' <br />�pB OfWOrJf WIIJ il9 CO/►1�1�9t9d Wh91f7B! SJ�C1r79fII]ef6ln al flOL iT/9 P�� /]S 0II3N'S 2fK1 Oldp73/R�5 <br />QOYEmf77Q NYS <br />tocal lew regulatirr9 consfrucGon or fhe ��+3 of a permit does not piasume to giva autdori(y to vioslalg or cancel the pravrsions of any other state ur <br />pe�'fo+7nence of cnns�ruction 7716t ! em euthorizsd bylhe ow� of this p�opertY to PeNwm the work for whic� applicetian is made and l <br />�n+PfY sNiFh tAe State Conb�clas Law J8.27 RCW anal 296200 WAC. <br />City nf Eve►att blTrcial Use Only <br />FEE <br />� 0 , c�0 <br />f <br />PERMIT # <br />- ,.-z � � E �C�o�( - � 2 � <br />rAuth dA9 Slgnature Dafe <br />(ftBvised f 0l12/2p15) <br />