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SIVA wi 6l• <br /> I <br /> ELECTRICAL PERMIT APLICATIL. <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT.WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 1 (E)everetteps@everettwa.gov j www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: CII(O PAGEF1L /"C <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-A'1TACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 74 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3 50 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 12t NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �S+ �t v Jvl Tr�G: C �"�t T7 .CJS i 1 - S ` ``JT3) <br /> .�•!� t1L� t�i. <br /> {'[4-YS1KrR I (.O0 <br /> Nt CONTACT INFORMATION' <br /> OWNER NAME: PRog i DE 10C E �t}C. -L CE? 't' k7 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTnesr tt_r+- 2,07 Qc, (� f t� <br /> CnY c'V E E-Tr. STATE K% A ZIP q "3 <br /> OWNER PHONE: 9-2-5-2(01-39 I OWNER EMAIL: <br /> c <br /> CONTRACTOR NAME: A2010SC6-� J-CvRAT-1 GaOUP <br /> CONTRACTOR ADDRESS: STREET ( OO C?1-�ZE,S.DALE [ <br /> STATE Lk, ZIP 1 cu5 t�] <br /> CONTRACTOR PHONE: 2C, - y - 355 3 CONTRACTOR EMAIL:PAUL.Aeon sale.A C,N. i�SE-C1.0 MY.7.c.:_c rri <br /> CONTRACTOR LIC.#(REQUIRED): A R.OMSS C 0 13 C (o CITY OF EVERETT BUSINESS LAC.#(REQUIRED):•Q31 c1 7 <br /> PRIMARY CONTACT: 0 OWNER 13 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: !CONTACT PHONE: 2 <br /> AGVt.- A CONTACT EMAIL: piwcI;CNSCki. �i2ut�5Cid :ECi f T 7 cevi <br /> EMENT hereby certify fiat 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 auihoet y to violate a a,,..e!the pr visions of Oily other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this properly 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 /> IPERMIT# <br /> OwnerlAuthorized Agent Signature Date (Revised 10/12/2015) <br />