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I.ECTRICAL PERMIT AFOLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: f}cI20 j064, S}. S( 5VEkEr7 WA' '96206 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 9 COMMERCIAL USE OF BUILDING: 4CA L714 C E�IJi C-�2 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ gyp. 00 NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES PNO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: INS7ALL (1) D F I IIUM1 A7CQ M,0VL n C-,vT S)(,tj9'x6 CONTACT INFORMATION OWNER NAME: Z/-/k A 0n1,n v1,7" 4{Ak(.7/4 (-(V7(-k TENANT NAME(If Commercial): .SA^c 4S oL,_ t. OWNER MAILING ADDRESS: STREET 16A10 S F}EA)I)C-4Sa C CITY SCAS77-F STATE WA ZIP OWNER PHONE: 2106 ?e6 3200 OWNER EMAIL: CONTRACTOR NAME: 6A7H ✓1047 WCrST CONTRACTOR ADDRESS: STREET `Z7 S 964' ce CITY STATE W4 ZIP 7 6/ CONTRACTOR PHONE: Za6 6Z3 3160 CONTRACTOR EMAIL: ea41,✓io'-wn lv'dt-Gunl CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER 1ACONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 62--'-, 3/06 K 1/-SAA o ,/Vs0 CONTACT EMAIL: AGREEMENT:T hereby certify that 1 have read and examined this application and 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE V PERMIT# Owner Ized Age r Date (Revised 10/12/2015)