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I <br /> I477 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 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> fav r F <br /> �1� ,�RNIO:o 5 <br /> PROJECT SITE'INFORMATIO L ;; <br /> PROJECT ADDRESS: 1'1/-10g 277h /We tj� ever 4L q '208 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED FR-ATTACHED/ 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING:go/1(9/ 7�l/(�J - (tel 0/145 Arem <br /> . . (J ELEciran/t A 6 "ATIU i ii MT141W "£ �;a ., -- 4 �.;,1E�.ri ` <br /> CONTRACT PRICE OF WORK: $ 2 3 Le 0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ,,A / <br /> DESCRIPTION OF WORK: I1 A nip �K- 1,t/ f e x----e*-i<Sl 8v-, of i&(_•n d-e(-!� <br /> vtid viticfer (,)&103in me-/ (ig h Is <br /> v <br /> 08GO 1ACT iNFORMATiON.. z <br /> OWNER NAME: de-f{' Orr-en TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1J' Ob 2'77 /Q'�d D' <br /> CITY p/(/'T y-e*- �� ][�STATE l�J, ' ZIP 09 V <br /> OWNER PHONE: (•42�✓) °l-134'0 OWNER EMAIL: N/f1- <br /> CONTRACTOR NAME: //4— f afAc Ff-eC Kic/�t/s•PiK✓f"c e'S, Int . <br /> CONTRACTOR ADDRESS: STREET //�� /30 //7 yen <br /> ih /��1242F �� } �Anr^d <br /> CITY hm./`G if7 V e l, .-:--: / STATE (/1,//,�,�,, , �n / ZIP-/i/Z <br /> CONTRACTOR PHONE: (-4.--i2 ')23q-o(,13 CONTRACTOR EMAIL: /fr C 2 ,g1 h e c/ec c-• t'.evy1 <br /> CONTRACTOR LIC.#(REQUIRED): /M/-tOU e-bo o&6I CITY OF EVERETT BUSINESS LIC.#(REQUIRED): P4/1-71/(0'e <br /> PRIMARY CONTACT: 0 OWNER 'ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: / CONTACT PHONE: 6471,2._ ) O — Sze 3 <br /> /< 4 9 CONTACT EMAIL: / reeviSiGgInGN`•GBn4 <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true Aacorrect. All probikions o/Yaks and ordinances governing this type <br /> 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 296.200 WAC. <br /> City of Everett Official Use Only <br /> ./ PERMIT# <br /> di Ai/ iIL 2 . 0./4- E t -76z -011 ( <br /> Ower/Authorized AgentSi. • re Date (Revised 9/23/2016) <br />