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/-"ip. - T1fL PERMITAPL A i <br /> . .14Y---.‘ <br /> Aigi _ CITY OF EVERETT T PER1VI11 SERVICES <br /> 3200 CEDAR STREET, EVERE I I, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everefteps@everettwa.gov I www.everettwa.gov/permits <br /> .:PROJECT:;SITE I., .... ATIOiV>:`.:,`: <br /> PROJECT ADDRESS: ,1(, 0 kr() "304- c 1 - s( - gs az, i <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ID SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTi-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: G(,.''g & r/1f�,A(i(,6 `�(.-1 <br /> . :,::::... ` ._.:;: ELECTRICAL:APPL'ICATION INFORMATION ' : :,:::::::::: :::.;::;'::: ',1':,..: : : ;:: : -'•':::: <br /> CONTRACT PRICE OF WORK:$ l 3 exi <br /> NUMBER OF DEVICES(if low voltage): 3 <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: I IASI-Att.. �r0,21. 3 p��} -L 1 m,ST'711-1-, <br /> 14 i V —Pt, , 708 v "P_ffi r sfee rr 5(Z. , 9P-44 (\i(\ CNICu,b T' R. <br /> Q tib Fi S I\\\%I. 1. -fp 12- CALL t, - WtThi-w6. <br /> CONTACT',It$00RiViAT1ON .'' <br /> OWNER NAME: WA-IA-50g C! V\fD TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEI-Lt-l/ � /►,a/4 \_y- s�& /y q <br /> CfIY IN v 4 iA,L1 v✓ STATE W\�-1 ZIP (/�.�5 <br /> OWNER PHONE: �J"633- 1 J 2 OWNER EMAIL: , S 1/ 'VI,$Aytiaw'p .14% <br /> CONTRACTOR NAME: 7ch_f LAA---4 .4:—;M 'Z CONri <br /> CONTRACTOR ADDRESS: STREEr ` �� -1S3 t , Se- <br /> CITY r:ki STATE W fir* ZIP 10Q v!L <br /> V <br /> CONTRACTOR PHONE:/496-331 JGO(,P CONTRACTOR EMAIL:1,v\' '�4,Ave aiv‘,L <br /> CONTRACTOR LIC.#(REQUIRED): <br /> !°' X149 105 Itaa F--if CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 1�j114 <br /> PRIMARY CONTACT: ❑OWNER NTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:gI�`� ,{� CONTACT PHONE: 5-3a.-�-9 it o6 <br /> $M )� + v 1 1 CONTACT EMAIL: T PV-0L7- /\ <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 lam 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 /> c_A.. .\ iii: .....A.... .._____, <br /> PERMIT# <br /> E (ge ( - [59 <br />