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0147T ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 'oo)Z t-174 Av-e- ,,t F_v.E4&1;7T, wA 9$2o4 BUILDING AREA(if residential, new construction, remodel, or addition) 3Z,00c' . j SF BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX EI MULTI-FAMILY-#OF UNITS: 92 0 COMMERCIAL USE OF BUILDING: RF_ tiNti.)7IIL ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ uu 3S v0o NUMBER OF DEVICES (if low voltage): t 0(0 FIRE ALARM? 4E1 YES 0 NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: R.E.Tizo Prr F12E ALNZ 5y$TErv. /A/ gvtt 1>tnJCo/ CONTACT INFORMATION OWNER NAME: 4_w)TWoop 1Jo2TN LC.,c_ TENANT NAME(If Commercial): 324eZTWoOf) POPArLTrh�NZS OWNER MAILING ADDRESS: STREET (4,)91 1)e,111 AVE SE CITY L• VvE STATE ‘Al/ ZIP 94300 le OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 13 i. N Ps a Aro° SG_c..0/Z„11"y t�L CONTRACTOR ADDRESS: STREET Box 13"71( p cm, Aal-1 NC-Tc7 rJ STATE WA ZIP /au3 CONTRACTOR PHONE: 4Z4i'" ZNL-/ )L-fy S CONTRACTOR EMAIL: —ZEfFQ8N1{f162.1:,Loy— CONTRACTOR LIC.#(REQUIRED): f3HF1Q1 4$0434 7-K\". CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: li zS 2N.-1 11/1-15' - -c.FP B(Losyp%to CONTACT EMAIL: -S -pc. cr] j3N)�F t2F LvY�-+ AGREEMENT:T hereby certify that t have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this 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 local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for 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# Owner/Authorized Agent Signature Date (Revised 10/12/2015)