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477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 144 2 0 -4 ` ;r t,r ,� aJ " a , IN #Mitt °mak t f o °-... . . WWF <br /> se ..,y},lS , ,. ... �3}`I`:=1,x="3:: �. ..�._. >., 4.. .-kU 3.x h'SNn-r,..§:,>«. +�: .� .:..:�:k...c.'t4�T,xc.`4_,�a,.��,�""�i`' : <br /> PROJECT ADDRESS: S O$ (15"11"‘ 4t (A) E tf c•55 Z04f - <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: .."{-(3l}t'-kou`k. <br /> •: �i <br /> CONTRACT PRICE OF WORK:$/ 05013 /1 <br /> NUMBER OF DEVICES(if low v Itage): l <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERM #((if.appplicable): <br /> DESCRIPTION OF WORK: A-O(tt . 4trft C i((U,tA d ,r'ire..Qt4t.e, AIAA T u <br /> l ri <br /> Vtv kv5 +Cc u w. . D ru 2-0 Amp (ire , t vu i I S Pc vp <br /> OWNER NAME: k"1.7.cke__.-‘--Arl El etry TENANT NAME(IE Commercial): <br /> OWNER MAILING ADDRESS: STREET 9:40 l ' Ave, c to. 103 � � <br /> GIT, Eve e+� C <br /> STATE V', ZIP ` $!G S.)4 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �ILG'MTrp{--C+ <br /> CONTRACTOR ADDRESS: STREET l2-t .1.Z Eitua tut (hs <br /> CITY �kk,l o STATE (J^r ZIP Q <br /> CONTRACTOR PHONE: 1-CIK (p12 -tv.1611 CONTRACTOR EMAIL: )1)-ShK e.\et*{' CE{EjlYk,•(aY"� <br /> CONTRACTOR LIC.#{REQUIRED) E L FGT I. * J IP 6 A CITY OF EVERETT BUSINESS LIG #(RREQUIREe 02 �j <br /> PRIMARY CONTACT: 0 OWNER ArCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: V Usr14 CONTACT PHONE: 42 6 ( 7� <br /> 5 CONTACT EMAIL:JUST IN® <br /> AGR T.T hereby certify that!have read and examined this application and know the same to be true and correct. Alt provisions of taws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit dyes 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 lam authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RC W and 296200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> -- --� VV AA E 'ZO1 - OSS <br /> O !Authorized Agent Signature Date (Revised 10/12/2015) <br />