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! LECTRQCAL PERMIT Fj�L�CATION <br /> a .;- r, CITY OF EVERETT PERMIT S VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425.257-8810 ) FAX 425-257-8857 1 (E) everefteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT ADDRESS: yip 0/ <br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED El DUPLEX 0 MULTI-FAMILY-*OF UNITS: <br /> 0 COMMERCIAL <br /> •USE OF BUILDING: �Qy� ( (�,�•�,, y,G t' . <br /> >ELECTRICAL APPL1FN <br /> CONTRACT PRICE OF WORK:$ 760 �II <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ,<NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): — <br /> DESCRIPTION OF WORK: f) R,f L c.e.- 2 X J i e�_c� 1�-c1- t,�i T1.� &zoo <br /> >:4..•<: ._.::..,:...•:-.... . _. :. ....:...:�..::;;_.:: CONTACtIhIFORMATION _�. :.:�` ..:. ..'•_. . _. . .- -_ - < . � _ _... .> <br /> OWNER NAMO s,. . TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET E/ 2/)1 1l (1(Th• <br /> A <br /> cm, P r2 i STATE WA- ZIP <br /> OWNER PHONE: OWNER EMAIL: • <br /> CONTRACTOR NAME: ..• ,(J&jT LO 4C..cc-cm; <br /> CONTRACTOR ADDRESS: STREET 6/;j . of 7 $ - ✓v/=_ 7 /F �� <br /> CrN c�/'�j l�/ r STATE /4 ZIP %1� Z <br /> CONTRACTOR PHONE: V ZS 7319-0v 1 9 CONTRACTOR EMAIL: t.)e67-cp ,kt <br /> CONTRACTOR LIC.#(REQUIRED): f N�53-c.t,L gib k J 41 rtCITY OF EVERETT BUSINESS LIC.*(REQUIRED):iff75. <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: �c�3T 12e CONTACT PHONE: y�ss_3),o y )9 <br /> /1 n i ,/1.,, 's CONTACT EMAIL: <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and 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 of this property to perform the work for which application is made and l <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> • l <br /> -t OD <br /> PERMIT* <br /> g/t2C-/ F 1( 401'r- 145 <br /> Owner/Autliorized Agent Signature Date . (Revised 10/12/2015) <br />