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11/18/2016 FRI 9: 34 Fax 425 252 1666 CM Heating �I002/003 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa,gov www.everettwa.gov/permits to.:a�',:r r; ,> �,:rrlM1•Y1r5''117t1 r: �} ( 1., <,ir;r. , y y�yM�,r,uy, �` r PROJECT ADDRESS' L200A41Z S-' ( + 0-1 BUILDING AREA(If resldentlal, now constructlon, remodel, or addition) 8F BUILDINGS TYPE: SFR-DETACHED ❑ SFR-ATTACHED CI DUPLEX ❑ MULTI-FAMILY-#OF UN ITS: COMMERCIAL USE OF BUILDING; ui11 Lf'. ray t. 1 �7'd r�l�.oi, vL v'� if1 u ., fur CONTRACT PRICE OF WORK; $ NUMBER OF DEVICES If low voltage): FIRE ALARM? ❑YES El NO ASSOCIATED RUILDING PERMIT# If a Ilcable : DESCRIPTION OF WORK: 4 ' 'iii::;`Yf-' '.Lr..ri�.. ',r;' Iifl ` �'�'.P` `.,n ,i •f, ;,�1''1' 6 'Nr', .a l.�';yo- .l Y. I r ,I 1-'^°W.J •I`• r�4� OWNER NAME: TENANT NAME If Commercial): OWNER MAILING ADDRESS: 8TRz� T �AW ) la( 5� vo(, — wll c,TY STATE V ' ' zF OWNER PHONE: a 3 -Zq3 OWNER EMAIL; CONTRACTOR NAME; CONTRACTOR ADDRESS; STREET CITY STATE ZIP CONTRACTOR PHONE:tl� O�Z7 CONTRACTOR EMAIL: CONTRACTOR LIC.#REQUIRED : CITY OF EVF-RETT 13USINESS LIC.#RECIUIRED PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME; `6 CONTACT PHONE: p —� -- CONTACT EMAIL; VftQjVr AGREEMENT:T hereby certify thaf I have read end examined this appNeatlon and know the sama to be true end correct. All provlslons of laws and ord r nces govarntng thls type of work will be eomMated whether spectflad harafn or not, The granting of a permll does not presume to glue authority to violeto or cancel the provlsfons of any other stare or kcal law regulating consiruotlon or the performanGo of oonstructicn, That t Am ouf ctlted by the owner of this property to perform the work for which appt(catlon Is made and I comply with the State Contractors Law 16,27 RCW and 266,201)WAC. City of Everett Officlal Use Only FEE PERMIT# [ [ Icy E �c.QcC �3Co OwMWAuthorhed Agent Signature pate (Revised 10/12/201.1)