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WLECTRICAL PERMIT 4PLICATWN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 j (E) everefteps@everettwa.gov j www.everettwa-gov1permits <br /> AV417 L`ak <br /> C <br /> PROJECTADDRESS. 1 ;'L- ST <br /> BUILDING AREA(if residential,new construction,remodel,or addifion) SF <br /> BUILDING TYPE: EISFR DETACHED EISFR-ATrAcHED ODUPLEX EI MULTI-FAMILY-#OF UNITS- XCOMMERCIAL <br /> USE OF BUILDING: :130.e,,A)Ei S5 <br /> SoEc <br /> • - :IFILPT�m,10 <br /> CONTRACT PRICE OF WORK. i5q oc) <br /> NUMBER OF DEVICES (if low voltage)". 29 <br /> FIRE ALARM? )AY-ES D NO <br /> ASSOCIATED BUILDING PERMIT#Cif applicable): <br /> DESCRIPTION-OF WORK: _T',P_f_ AL.Ar,_V-1 <br /> CORt. [ON ' <br /> TENANT NAME(if Commercial): <br /> 0 -T <br /> Eft cam rNC �; <br /> )f.'j k <br /> FCOWNER MAILING ADDRESS. STREET :3 SCJ t CCt-94 AVi'_ <br /> cny t\j,;JL1,:-1, j sTA7r= <br /> OWNER PHONE: IOWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET Po 8 r, 17 11 <br /> MY STATE zip <br /> CONTRACTOR PHONE: 4Z`5 ZqH 1H14S_ CONTRACTOR EMAIL: �t4-A-jL, 4_0YY'\ <br /> CONTRACTOR LIC.#(REQUIRED). clTy OF EVERETT BUSINESS LIC.#(REQUIRED); <br /> ' RU <br /> PRIMARY CONTACT. 0 OWNER CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: J�Z.5 z(4c, j Ll cI<fSt <br /> CONTACT EMAIL: RtJ H Fi RY_- � <br /> -pip <br /> AGREEMENT-Thereby ceifflythat/have read and examined this appricaffon and know the same to be true and_conucL <br /> Al!provisions oflaws and ordinances governing this <br /> type of work will be completed whetherspecified herein ornot. The granting of permit does not presume to give authority to violate orcancel the provisions of any otherstate of <br /> locallawreguiaffngconstruction orthaperformance ofconstruction. That I am authodzedbythe ownerofthispropertylo perform the work forwhich application is made and I <br /> comply with the State Contractors Law 18.27RCWand296.200 WAC. City ofEverett official Use Only <br /> FEq <br /> (Do <br /> $ is/. <br /> PERMIT# —1 <br /> E: -A/0!5 A6 <br /> 4t e (Revised 1011212015) <br /> r/Autficrized Agent Signature ate <br />