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/111111A
<br /> eLEGTRICAL PERMIT AF;rLl e4TlON
<br /> *►' CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov j www.everettwa.gov/permits
<br /> PROJECT SITE INFORMATION pp
<br /> PROJECT ADDRESS: cA< >Of\ )-e�v A. -a,•r1 3-100 ce..,4-1,-a..x bwe., w.v�'* .A `''t c�i'2.C)t
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) 1-1-t23(:)''' SF » AQQYoX. -b a c- o
<br /> BUILDING TYPE 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ■COMMERCE
<br /> USE OF BUILDING: 5 c._\" cx›N -• per.,.-A, y\2,s5.,,c or..Y -* 3
<br /> ELECTRICAL APPLICATION INFORMATION
<br /> CONTRACT PRICE OF WORK: $ 2.,.- S Z Gj
<br /> NUMBER OF DEVICES (if low voltage):
<br /> FIRE ALARM? IN YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: i
<br /> Ac\c. ,,,3 .,„` c c_ \ S Y1
<br /> �' c_ \--eA,..,c.cyvv,, c;se-`e.. alarm Yh 1
<br /> V-0 iNe-v3 por4-a1 \,\;v-, - .vv 5tivoc-D .
<br /> CONTACT INFORMATION
<br /> OWNER NAME: cv.ev'o ev t;c_ s,.....\-,(:),,,\ 5 TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTREET (3...-.\1--.2
<br /> 1 OC) Q% O ,
<br /> 3kic va \W qVa t
<br /> CITY 't.V`4 y Q, STATE . ZIP 2-0,
<br /> OWNER PHONE: .12 5— 5R)'5 - Lit Q% 5 OWNER EMAIL: 5c a t)i A 5 a, e\/e`C Q S d . 0,"
<br /> CONTRACTOR NAME: S eA,1 e `�') Ec�\--A C `.n .
<br /> CONTRACTOR ADDRESS: STREET \-11 '2:-- 't-sw,y1 eA. u,--,,
<br /> cry v.:>>/ STATE \. 4 ZIP l 2,0 3
<br /> CONTRACTOR PHONE: ''�`'c6- LIC3`t- '7,'82, CONTRACTOR EMAIL: *'Ya'�1.I5 C s4..QP,\q_A,,C.-CO
<br /> vsn
<br /> CONTRACTOR LIC.#(REQUIRED): S I£ L E 1 5 LI S. c. S CITY OF EVERETT BUSINESS LIC.#(REQUIRED):
<br /> PRIMARY CONTACT: 0 OWNER JIKCONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: , CONTACT PHONE La-Z S- g 7 ! _-"7 '—k ,it,T Y''^c}`,� t 5 CONTACT EMAIL: ,rz�t;5 `' v,,\
<br /> AGREEMENT:T hereby certify that f have read and examined this application and know the same to be five 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 I am authorized by the owner of this property to perform the work for which application is made and I
<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 ( I 7:
<br /> j� PERMIT#
<br /> d � H.111(0
<br /> f I O� O
<br /> f OwnerlAut ionzed Agent Signature ,., Date . ,i
<br /> j ' {Revised tOlf2f2015)
<br />
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