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Aug. 30. 2016 1 : 40PM No. 1313 F. 1 <br /> - F—=—�4tErr <br /> CTRICAL PERMIT AP CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permlts <br /> PR'OJ.ECT I'NF'ORMATION <br /> PROJECT ADDRE=SS: • , <br /> BUILDING AREA(if res ental, new construction, model, or addltIon) SoZdd SF <br /> BUILDING TYPE: ❑ SAF -DETACHED 'CI}SFR-ATTACHED CI DUPLEX ID MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: e lA_ U V.,' CTh <br /> ELECTRICAL APPLICA ION;INFO'RMATI,ON <br /> CONTRACT PRICE OF WORK: $ 50&a. <br /> NUMBER OF DEVICES (if low voftage) <br /> FIRE ALARM? D YES ANO <br /> ASSOCIATED BUILDING PERMIT# (If applicable): _ <br /> DESCRIPTION OF WORK: i. "(1.41.6i1../ <br /> frijiliPt. <br /> .mac <br /> - 1 <br /> CONTACT;INFORMATION • ' /64-.11-4C I` <br /> OWNER NAME: MU Fl u fy«n TENANT NAME(If Commercial): �t Or. /� ` <br /> OWNER MAILING ADDRESS: MEET ,2. � <br /> f5/ � e_i <br /> CITY TATE )414- <br /> - 4 ZIP I V e/ <br /> OWNER PHONE: OWNER EMAIL: • <br /> . <br /> CONTRACTOR NAME: . J.t r- <br /> CONTRACTOR ADDRESS; STREET 1 i la /0 ,ei if S 1+i j/ _ <br /> Crry _ETAT:— 7 � (�/O,/,, ZIP !4 a t3.4 <br /> r�� T/ " /� <br /> CONTRACTOR PHONE:0 _ J?I CONTRACTOR EMAIL: WMG 1-10-7-4 <br /> CONTRACTOR LIC...#REQUIRED): ygrde t <br /> . ._..C.._ITY O, F EVERETT BUSIN LIC.#-(REQ.,UIRED ,..5-07 ig: ...: _ , <br /> PRIMARY CONTACT: <br /> ....., <br /> ❑ OWNER 1,ONTRACTOR 'STHf=R(Please Specify) ge4,1 <br /> CONTACT NAME: CONTACT PHONE:Crt+61) 7 b - 7.13 <br /> 9� <br /> wCONTACT EMAIL. �` `tb ,, } e,--,,_ <br /> AGREEMENT:T hereby ce Ify that I have read and examined this application and know the same to be true and correct. All provisions f ws and ordinancegoverning 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 l am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors 1,aw 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> • <br /> - ®O <br /> PERMIT# <br /> Z ' ,/ // <br /> qi, E Voog 62-3OwnerlAuthorl - Agent Signature (Revised 10/12/2015) <br />