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�������/�� �� �� ,���������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)426-257-8810 � FAX 425-257-8857 � (E)everetteps@everetiwa.gov� www.everettvva.gov/permits <br /> ,,, _ . . , _ <br /> t .;. � ; PRAJEG7'SI`�°E IIV��tttVIATIOi�I � <br /> , . .. ,. .. _:. ,. .. <br /> ,.: _ _ _ __ .. , ... <br /> PROJECT ADDRESS. � Z ��141� (it� � <br /> BUILDING AREA(if residential,new construction,remodel,or addition) � � SF � <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATT/�CHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUfLD[NG: � �(� � <br /> _, ,. _ . .. ,. ,::. , : <br /> :--- . ., ... . .. . <br /> _.. <br /> .,. ,. <br /> . _ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ � 2p�j � � <br /> NUMBER OF DEVICES(ifi low voltage):� <br /> F1RE ALARM? ❑YES NO <br /> ASSOCIATED BUILAING PERMIT#(if applicable): <br /> DESCR(PTION OF WORK: R� L � (� �I���--G�l— P�'J'/� <br /> � C� F�c- �c�- r� � ���z�C . <br /> . _ .:. . . . .. _ . - <br /> .. . _ <br /> . _ - <br /> : . _ . : _.,.: . :CONTACT:INPORMATION.. . _ <br /> OWNER NAME: Iv���, �(,�. TENANT NAME(If Commerciai): �C-v�( '�j p G�L'J <br /> OWNER MAILING ADDRESS: s-rRee-r l Z, �jlL.�,�, <br /> CIIY �V� STATE �it� ZIP �� <br /> OWNER PHONE: �LO� OWNER EMAIL: <br /> CONTRACTOR NAME: ���� �L��Q-�G <br /> CONTRACTOR ADDRESS: sraeEr �Z p � � � <br /> CITY ��I/l�1/�-l�l� ��"v STATE Vv/� ZfP g�3 <br /> CONTRACTORPHONE: �Gad �I Ie (jZZ7 CONTRACTOREMAIL: aUi �l�d'!�!'[�1G�L'��G`�(`lC.Ca <br /> CONTRACTOR L[C.#(REQUIRED): CITY OF EVERETT BUSWESS LIC.#(REQUIRED): �,Jf�O <br /> PRIMARY CONTACT:��0 OWNER xx I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACTPHONE: '� � O " �� � - �j ZZ� <br /> e��V� j� �` CONTACT EMAIL: Q�/� � ��i2YYtCt.,_�' �C�'/�I(�.�CsKr <br /> AGREEMENT.�T hereby certify that 1 have read and examined this application and know the same to be true and crorrect, Al!provisions of/aws and ordinances governing this <br /> fype of work will be completed whether specified herein or not. The granting of a permit does nof presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating constatction or fhe performance of construction. That I am aufhorized by the owner of this property to perform the work for which applicafion is made and! <br /> comply with the State Contractors Law 98.27 RCW and 296 200 WkC <br /> City of Evereft Official Use Only <br /> FEE <br /> � �� og-�� <br /> PERMIT# <br /> ` ������t� E �7 (� — 2�� <br /> Owner/Authorized A t Signafure Date (Revised 10/12/2095) <br />