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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE=, EVERETT, WA 9'3201 <br /> (P)425-257-8810 PAX 425-257-5857 1 (E)everetteps(geveretlwa.gov I vAvw.everettwa.qov1permRs <br /> PROJECT ADDRESS:. <br /> BUILDING AREA(it Tesidenbal,now construction,remodel,or ad&6) SF <br /> - <br /> BUILDING TYPE: 13SFR-DETACHED MSFR-ATTAGH E3 D4LEX muLTi.FAmiLY-#or- JNITS: 13 COMMERCIAL <br /> IUSE OF BUILDING: C m 0 S <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES if low volts be): <br /> FIRE ALARM? 0 YES � <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK- A I L,3 cv—(c- <br /> A)-e� <br /> . (C <br /> 6"- d <br /> OWNER NAME: L aVe- Sk-pre Cb'-A-C�S TENANT NAME if Commercial) <br /> OWNER MAILING ADDRESS: STREET <br /> OTTY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: r-P, <br /> CONTRACTOR ADDRESS: STREET <br /> crry STATE ZIP <br /> CONTRACTOR PHONE: CL ICONTPACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRFzQ): ICITY OF EVERETT BU I INESS LIC.#(REQUIRED),',-,) <br /> PRIMARY CONTACT: ElOWNER '?C=NTRACTQR 0 OTHER(Please Specify) <br /> CONTACTNAME: [CONTACT PHONE: <br /> -F0 CONTACT EMAIL: <br /> AGRVENT.I hereby certify that)h6v'read and examined this appffcallonand know the same to be true and correct. Al!pro%delons of laws and ordinances governing this type <br /> of work will be completed whether specified hereby ornot. The granting of a permit d0&S not presume to give atjthoh'y to viol reorcancel the prm4slom of any other state or <br /> lacqf law regulating construction or the joerlbrmence of construction. That/am authorized by the owner of this property toper brm the work for which application Is made and I <br /> comply with tha State Contractors Law 18.29 RGW and 290.200 WAC. <br /> City of Everett official Use Only <br /> PERMIT 4 <br /> f--\ - <br /> E I ��3 <br /> Owner/Authorized Agent Signature Date (Ravjs6d 9129I2016) <br /> z0/zo 39vcl OIdi3313 -71IH <br />