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-LEC` TICAL PERMIT 9WLICA 1 ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425•-257-8810 FAX 425-257-8857 ] (E) everetteps@everettwa.gov j www.everettwa.gov/permits <br /> P1RO' CT s1` "FOR <br /> > <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential,new construction,remodel,or addition) Sr <br /> SP <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: V 1 A '' >'q 4?� ,rip= <br /> _� <br /> IFIL ECTRICt4!= A�ff'11.9�A7'll®N IINFORM,�T�ON <br /> CONTRACT PRICE OF WORK:$ p 4000 <br /> NUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? ❑YES Z"N0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: r,�,�119 r5 t�2(J/GG Ic X00 — r� ,r} `vsriz <br /> FOWNER <br /> : 3 . <br /> FORMATION .NEFt NAME:.." µNTD .4 5 `✓' TENANT NAME(If Commercial): <br /> MAILING ADDRESS: STREET 2,121j— 1V0e7"1`4Al ry i2 042(t1C'- -5 <br /> ` CITY ' kL" %l1 . le 4 STATE /V)/5l ZIP <br /> OWNER PHONE: ?G OWNER EMAIL:VO A 5 TD iv(SA,0Qi4-4t)7`O , C:0 w <br /> CONTRACTOR NAME: � /aCk'u �GEGTI�IG pG LGN <br /> CONTRACTOR ADDRESS: STREET L•64C�7L/ fid0 <br /> CITY 6 o?'*I1.O I,tj!i/Q A- /> STATE /4 ZIP <br /> CONTRACTOR PHONE: 366) —" SD CONTRACTOR EMAIL: <br /> CONTRACTOR LIC,#(REQUIRED): aefaCk kC 2,3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):1�S3�Y <br /> PRIMARY CONTACT:x 'OWNER EI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> /�/ - y 7 CONTACT EMAIL: �,��l�'l�'�/GC qty/lid /lam� E o4, <br /> AGREEMENT. Thereby certify that/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 ornoL 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 t 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 98.27 RCWand 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> i <br /> A <br /> ' I <br /> PERMIT# I <br /> CC� a � - No I <br /> Owner/Auto rizedAgentSignature D (Revised 10/1212095) <br />