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2017-06-19 10:28 1 13 » 425 257 8857 P 2/2 <br /> 47-1- ECTRICAL PERMIT APRICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa,gov f www.everettwa.gov/permits <br /> PIROJEet 5i1 'ili RMATIoN' <br /> PROJECT ADDRESS: 3 4 3 'TULt.i yD f 4— <br /> BUILDING AREA(if residential,new constructio,, remade a addition SF <br /> BUILDING TYPE: 0 SFR-DETACHED .SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS;_-` 0 COMMERCIAL <br /> USE OF BUILDING: R'St I3 )Tt Vit, <br /> ELEC"T"RICAL APP .t rr:Ai i aN !NFORIM ATIgN <br /> CONTRACT PRICE OF WORK: $ Z( v <br /> NUMBER OF DEVICES it iow voita e : <br /> FIRE ALARM? 0 YES iftINO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: • (10 1 _C e <br /> CONTACT INFORMATION <br /> OWNER NAME: u Arr. TENANT NAMEJII Commercial): <br /> OWNER MAILING ADDRESS: ST RF T 7 I 0 t)Q0C)0_,L1.44.tiPrOCL. lug. <br /> t=ry .c<r'r2-7 S1ATE L A..4 - ZIP Ft if-- <br /> OWNER PHONE:x{'7,1`•-,�`OJ s pg ,Y'- !OWNER EMAIL: Aclot- ' <br /> CONTRACTOR NAME: C.11? , J C--.0 .T t K <br /> CONTRACTOR ADDRESS: SPEET ��} �^y„( 7'C4-- <br /> GITV Ar A--►W1`? to STATE-""' ZIP lien? <br /> CONTRACTOR PHONE: 340—("0---- woe, !CONTRACTOR EMAIL: O...JiO�/tt, CO Lvc t CQ <br /> CONTRACTOR LIC.#(REQUIRED): CO/2A-1-3; 1 2�✓h CITY OF EVERETT BUSINESS LIC,#(REQUIRED): 02,yg <br /> PRIMARY CONTACT: 0 OWNER )(CONTRACTOR C OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 36 a-(13,).-.^ 4 1.+ -.......__ <br /> '� t__,_1-� ( f,,: CONTACT EMAIL: <br /> AGREEMENT.'I hereby Certify that 1 h ve read and examined tills application and know rho same to Cu true and correct. All pr talons of laws and ordinances governing this typo' <br /> of work will be completed whothor ap eifted heroin or not. Tho 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 performericv 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 Slate Contractors Law 10.27 hICW and 206,200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> Owner/Authorizec <br /> kure Cate (Revised 612312016) <br />