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• • <br /> ELECTRICAL PERMIT APPLICATION,i/A,„4,....r!...,—,.. <br /> - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR:STREET,.EVERETT,WA 982(}1 <br /> 414-4W.2.67,881.0,4.F 42&• 57-8857 J C everej sef Ve ettwa is vAlAr a a Qvpermits. <br /> PROJECT-ADDRESS ' 1 6 f``CJCvk A"e+ lr ST e,r-.--1-1— WA 967401 <br /> ti <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 14 to 258 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX itV MULTI-FAMILY-#OF UNITS: 61 : D COMMERCIAL <br /> t F'BUfU*4C' f Ais,o mitis gtY\t3 . <br /> " JII�iF>.41'"ii un[ ii:oyooitca . . <br /> • <br /> CONTRACT PRICE OF WORK:s 1 f©O IC) • <br /> NUMBER OF DEVICES(If low v Cage): t{` , <br /> FIRE ALARM? VAYES w 'O <br /> SSOCIATED BUILDING PERliA # O.-16: •-,,i. ,, • a <br /> DESCRIPTION.OF1IVORK i{/ ‘AC , Sl-y()kt,e, byr nary-)Lar t G" kS,a. <br /> . <br /> ) <br /> ttY'11 : <br /> OWNER NAME:. i ..-Vcve-tFu51 Akkx-irkirigAELTtifAVIE f:Gat nxet t 4ZiG1; ..,rrIS <br /> `,©'L t5 <br /> OWNER MAILING ADDRESS: STREET `P <br /> cm( o'd'e.Y STATE VA ZIP C3 2ii <br /> OWNER PHONE: 14 2-5 -02 ^Q)-22-2- OWNER EMAIL: <br /> ONTRRACTOR.NAME: SySfie YY\ ,D1,1.4_,-6.OY O - <br /> ConlT�cT.Oi7�alxtt�ss: ;lamer `?O l'�ox �j �% 1I <br /> CnY1.--A 11 n( ` V <br /> STATE A MP 9B140-CONT-RACTOR-PNONE(4 Z5 ti`"k� f118 jCONT•I ACTOR- MAIL: Yl(� r( -- St aiSe 4-g:- k iNa e <br /> -o C� <br /> CONTRACTOR LIG.#(REQUIRED2 SST 1r,,,+ n3P___19.7 OF EVERETT BUSINESS LIC.#(REQUI• D•OS 02-29 <br /> PRIMARY CONTACT: D OWNER CONTRACTOR D OTHER.,(Please Aped00 <br /> . <br /> .aCON3'.ACT NAME: ONVACT PHONE: aou 91. tictcaS <br /> . 11-P 1 Y c0ri CONTACT'EMAIL: <br /> r G� �'2 r--011+0\Q-1- 0S. YYI tA-�-�y�Wa ,y .. <br /> AGREEMENT:T hereby certify that f have read and exartilned this appifcatton and know the same to be true and correct. Al!proins of laws and ordinances governing this. <br /> type of work wNbe 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 t <br /> kcal law regulating construction or the performance ot'construcfion. That l em authorized by the ownerofthispropertytarperfornrthe work for which application is made and i <br /> comply with the State Contractors Law 18.27 ROW and 20.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 23S _° <br /> - <br /> PERMIT-# <br /> Ni-br. zi . E tit 2.. - k2 <br /> Owner/Authorized Agent nature Date (Revised 10/12/2016) <br /> 8 <br /> 1 <br />