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477 CTRICAL PERMIT AP .ICATION <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 I www.everettwa.gov/permits <br /> • / r , <br /> /. <br /> / <br /> �,� <br /> /} <br /> PROJECT ADDRESS: 7c/9p t2 / ZL`7 ,1 i"G 5 _ ���"et ft ki Y42/20.‘" <br /> BUILDING AREA(if residential, new construction, remodel, or addition)_ 4/ 3 J SF �,/ <br /> BUILDING TYPE: 0 SFR-DETACHED ID SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: IIJ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 7_3 <br /> NUMBER OF DEVICES (if low voltage): ./0 <br /> FIRE ALARM? b YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#A� , <br /> (if�applicable): <br /> DESCRIPTION OF WORK: Ate c//:4 i2s'J fr/zik 8,e/S/7' /-/ _c <br /> ii; CONTAC' _ � <br /> OWNER NAME: TENANT NAME(If Commercial): k ' 'P"" <br /> OWNER MAILING ADDRESS: STREET 3,7-3— 7'd0/4 /}G�e�A�S j /4e, G� n �^ <br /> !3 Q//{may�� CITY ,r� vY STATE ZIP Jrb�J <br /> OWNER PHONE: W G o23 0 . oeJ!/L' (OWNER EMAIL: <br /> CONTRACTOR NAME: Q (R/ 1/Vlit� s is edLr S/ y <br /> CONTRACTOR ADDRESS: STREET P9 A 7/ /4/02 <br /> CITY 407/ 1//&L- STATE 1:44/7Z ZIP J 714. <br /> CONTRACTOR PHONE: 2 9/-/i! %r/ -9P 'CONTRACTOR EMAIL: eie,,ei7e=CGT /e7 i-/'1z tT -----C;75/4""'S <br /> f5/P s. el7ke, <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0 lro!73,3 <br /> PRIMARY CONTACT: 0 OWNER Lu CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: ( r LL "67 0f/bf s CONTACT PHONE: y,Z.5 yy0(-' <br /> CONTACT EMAIL: �,� S !✓C�' 9,2d:13 <br /> AGREEMENT:T hereby certify that 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 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 /> PERMIT# <br /> E <br /> Owner/Author ed gent Signature Date (Revised 10/12/2015) <br />