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_ •ELECTRCALPERTJa PLICATION <br /> IO <br /> (' 1-. CITY OF EVERETT PERMIT SERVICES <br /> ��' 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 J (E) everetteps@everettwa.gov J www.everettwa.gov/permits <br /> :•: <br /> P <br /> i;OJ CCT§11`'IE.11.NF : 9 P.TI[® :: <br /> PROJECT ADDRESS: 1.906' l/‘&.0 OL. ..'-A3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) cg <br /> C:, ' SF <br /> BUILDING TYPE: ❑SFR-DETACHED El SFR-ATI-ACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: OMMERCIAL <br /> USE OF BUILDING_ \V cj� •• <br /> .- ... - <br /> : •�I�EC�`TR�CAL>,AII�Ii�1�QCA1111om 11r,'I�©IkP:A�'Qd'i.,! •..:. :.:-: •::. ".>. <br /> ,CONTRACT PRiCE OF WORK:$ i v— C <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? ❑YES XNO - <br /> I <br /> ASSOCIATED BUILDING PERMIT#Of applicable): <br /> DESCRIPTION OF WORkC: �OLNk Cc. �l�cl kiC\ ""\ .c • \CL NAQ\ki <br /> OWNER NAME. Y 4e TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZIP <br /> OWNER PHONE: qq OWNER� EMAiL: <br /> CONTRACTOR NAME: W1 i`C. Z3"C-S �C'XC WN! 5 , _.. .Le-- .. . . ._ . ,. <br /> CONTRACTOR ADDRESS: sTREEr t la �C S�'� V <br /> � <br /> fcm, -ft�V.‘(\ V"\... 1 STATEP.N- ZIP C�e q' ' <br /> CONTRACTOR PHONE:1Z '2 tO' i_i� CONTRACTOR EMAIL ;L' v\\\x,1)5 to (3l \.CC v- .. <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LiC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER NTRACTOR 0 OTHER(Please Specify) <br /> CONTACT AME • CONTACT PHONE: Lt 22)) z lb")--Trbr <br /> . • _c___ y CONTACT EMAIL: 11\ ,\`•c,(2.0 DAs---2_,, v3p,k..& V../1<„xj ...,C6 <br /> AGREEMENT Thereby certify that I have read and examined this application and knowthe same to be true and correct All provisions of laws and o nances governing this <br /> 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 <br /> local law regulating constrriction or the performance of construction. That l 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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4 ...-i, ....- <br /> ,. <br /> '1 <br /> ,_ <br /> '/ PERMIT# 1 <br /> -.0111111111111111 ,o, E 11( D - 0(0( <br /> .wner/.�riSignature itate (Revised 10/92/2015) <br />