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0 ELECTRICAL PE 3 APPLICATION <br /> *.�� rCITY OF EVERET T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE T, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> '''-- SI <br /> PROJECT'SITE INFORM`ilOF1: <br /> PROJECT ADDRESS: �l5 -�—�,I try 'C7Vr---(7ir-/WA- gi5co 1 <br /> BUILDING AREA(if residential, new construction,remode,or addition) SF <br /> BUILDING TYPE: -DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-if OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: . I Ocy 'fl <br /> ;, ELECTRICAL APPLICATIOM gMFOy uOM <br /> CONTRACT PRICE OF WORK:$ ( l31 O ---• � <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: A-. La Mt I ., . A/ t A M 1L Q} .y <br /> D ' <br /> P1 U A 'Are Ali AT A .V. 4 PI)+A , sem,) .. e• <br /> TOf - , ( <br /> ;C.ONTACT',INFORNIATION <br /> OWNER NAME: /" `El--1/ -E TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET'S I S MI VIM AVE- <br /> 1 CITY 4/ STATE Vii P Z flO 2-✓ I <br /> OWNER PHONE: -"O1orf--Iia-a OWNER EMAIL:? IZEtrYF \`, C,,s1. ,,,It,-- <br /> J <br /> CONTRACTOR NAME: i L - G, - ' e 1 Z <br /> !CONTRACTOR ADDRESS: STREET' 153 t 3‘br.A"N" 'Sc <br /> ! Crry ,i Ltrp'_. V STATE /1 A. A z €2. -O <br /> CONTRACTOR PHONE: 3 a1''� if' CONTRACTOR EMAIL: ' ,bp a Ad C cS-MA,U(r? <br /> (CONTRACTOR LIC.#(REQUIRED): viA•O L a v..ue CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 3114 <br /> PRIMARY CONTACT: 0 OWNER JNTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: J J� CONTACT PHONE:(�aCJ,-3a1—arc , <br /> 1\\ ,i CONTACT EMAIL: 13Thill-0 , VIVI.Lvrn <br /> AGREEMENT::T hereby certify that I 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 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 construction or the performance of construction. That I 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 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 1 "2.- <br /> PERMIT# <br />