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WOES 4253223792 p.1 <br /> 4/77 CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov f www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: J L;.',} '` - ^� 1 — 'w'� <br /> BUILDING AREA(if residential, new construction,remodel,or addition) /I, O SF <br /> BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: _ p,COMMERCIAL <br /> USE OF BUILDING: f;;" 7,C �?�'( !� ^ .I,. <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ �-I,G:<% c " <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0..NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> i <br /> DESCRIPTION OF WORK: �':,�< ( i;<: <br /> CONTACT INFORMATION <br /> OWNER NAME: =,r c c ;??mss. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ice- 0 7.-)e) . ' j9 <br /> cay STATE tLf'/ ZIP IF: <br /> OWNER PHONE: OWNER EMAIL: ,,,.t Z J.. '> ���1�4 n,t <br /> CONTRACTOR NAME: J;, '�";� ti a r { C� i �'' r'U <br /> CONTRACTOR ADDRESS: STREET k77s2. �' �xZ�i`li�'�< `r <br /> CRY I-) (CONTRACTOR <br /> ai STATE 1/44, ZIP KUCJs-3 <br /> CONTRACTOR PHONE: `��-- // <br /> ��% <<?�`v EMAIL: /21-(,e. <br /> w!1���ti,� �%�,. L�L2�'" 'r_C �`�•(C'/i-7 <br /> CONTRACTOR LIC.#(REQUIRED): t/(;:✓c �� r� ` G < ':- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ✓ ?` <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: LI C <br /> CONTACT EMAIL: .1/7 ✓ _'i r � S "(JZ <br /> AGREEMENT T hereby certify that l have read and examined this application and know the same to be true and correct. A/I provisions of Jaws 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 1• <br /> ( 6�. Sa <br /> PERMIT# <br /> _ �L�. E1606 - 115 <br />