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•LECTRCAL PERM- A. UUCATION <br /> ( CITY OF EVERETT PERMIT SERVICES <br /> rr <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 /> P:'OJI CT SITE fl I1F®R MATg I h' <br /> PROJECT ADDRESS: g j/ 14/E-7 0)? ,A V E l �T <br /> BUILDING AREA(if residential,new construction, remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED ❑DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRIC,.IL APPLICATION INFO 1i'I ATO*1NI <br /> !CONTRACT PRICE OF WORK:$ r(9 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: T M Pc)p tI- P >>' <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Mak S ILL! c-i?1 C £1Z vice L - <br /> CONTRACTOR ADDRESS: STREET 6z��° it/ 2 d 2 /11.0CIT <br /> Y 5/71�v R /ALE STATE IA//I.-- ZIP 9e/33 <br /> CONTRACTOR PHONE: 0.4, ,3 3 gZ,'9 CONTRACTOR EMAIL: Py L V/1/) CA:)/1-1 <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 7)eb' <br /> PRIMARY CONTACT: 0 OWNER I -CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 7 .35 3 g 2 cy <br /> c- CONTACT EMAIL: ) vLV A/ 42 y4 60,1 <br /> AGREEMENT:T hereby certify that!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 29E200 WAC. <br /> City of Everett Official Use Only <br /> FEE --- <br /> PERMIT# <br /> 111 E \ 1- <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />