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Jun. 24. 2016 3 : 36PM No. 3161 P. 2 MINECTRICAL PERMIT AP .ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8610 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www-everettwa.gov/permits PRO'JECT;SITE':;]NFORMATION PROJECT ADDRESS: b21-\ 613 P—r, �T SuJ BUILDING AREA(If residential,new construction, remodel, or addition) 1-WA SF _ BUILDING TYPE: 1SFR-DETACHED CI SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: &l.b 0.-cI F( :,ELECTRICAL.AP.,:P��C�ITNON INFORMATION; CONTRACT PRICE OF WORK; $ NUMBER OF DEVICES (if low voltacje): FIRE ALARM? 0 YES ❑ NO ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIPTION OF WORK: [f�1��r.l L '(W 0 -1 (\mc �2C )4erz`. • CONTACT INFORMATION OWNER NAME: 'Iv lp�1 Lc," (Z-P 7)2_ TENANT NAME(If Commercial); OWNER MAILING ADDRESS: STREET1)'\ SU.)1j�2 L� c( SVt l /� CfY V 1 16,/ l STATE LU ZIP 9 B7 01-4 OWNER PHONE: L- Z -.(67l.p— I ko7,�} OWNER EMAIL: CONTRACTOR NAME: (9 CONTRACTOR ADDRESS: aTREET1/1()CI kiV 6 fY f'V pp� //� CITY CiVL��I STATE T7 ZIP �I s7 CONTRACTOR PHONE; L j j5Z VI U U7_ CONTRACTOR EMAIL: EDCKI &ski' G r(��••t� CONTRACTOR LIC.fl(REQU[RED): &SO' CT-� (2vf 1/ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): oLg6e f K 17b PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT;T hereby certify that t have read and examined this application end know the same to be true and correct. All provisions of laws and ordinances governing this 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 local law regulating construction or the performance of construction. That lam authorized by the owner of this property fo perform the work for which epplicaiion Is made and I comply with the State Contractors Law 18.27 RCW and 286.200 WAC. City of Everett Official Use Only FEE ! PERMIT# Z,/2 //c� E 16,06 — ' 7 Z Owner/Authorizod Agent Sig 9ture Date (Revised 10/12/2015)