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E�ECT <br /> RICAL PERMIT �►P�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEL�AR STl3E�T,EUERET7, !!!/A a�201 <br /> (P)425-257-8814 � FAX 425-257-8857 � (E)everetteps@everettwa.gov ( www.everettwa.gov/permits <br /> PR+DJECT SITE INFORMATI4N : <br /> PROJECT ADDRESS: Q � �2.v�-+j��y/ <br /> �� <br /> BUILDING AREA(if residential,new construction,remodel,or addition} SF <br /> �UI�pIN('.�TYP�: C❑SFR-f)FT,qrHF'Il []SFR-ATI'qt�HFl� C�f}t�Pl FX ❑�1/Illl TI-FAIVIII Y-#(�F I:INITS• ��MN�F.Rf;Iql <br /> USE OF BUILDING: �"�-d�✓W�- pF � �.�-y9.:s-=O�f <br /> ELECTRI�AL APPI.ICATION;INFORMATION <br /> CONTRACT PRICE OF WORK:$ ,p�v� ApC� <br /> �NUMBER OF DEVICES(if low volta e): ' <br /> �Fir^«��AP3�"v7�' ��r'c$ '�t+�� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �►!S'� ` ��2j �;� ,� ,,,,�� <br /> � J��1-'r'�c� J+L'/!/�, <br /> �fl /'?� � � vrc:� / 2,4�/s�'--cs2.�2� 2 <br /> ' ✓Y' `S' ' ...�' ' �y�� <br /> � �o� <br /> �ONTACT INFORMATION <br /> __ : „ <br /> OWNER NAME: �/� �,e�j�/y�,�syj��/% ' TENANT NAME(If Commerci : <br /> �:�5�ldE°'R9^�!'�!!uv A.^.Q!?�5�: �Tc;EET <br /> C� STATE <br /> ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: DZv�Q_ �'!� C.L.0 <br /> CGiv"i r^�Av^i^v'ri niJi'�'�3@��: s iKEe i t�✓' 0.3 JY'c-�'9Z .E - L/�� � <br /> arv �G/Y I STATE ziP D3 <br /> CONTRACTOR PHONE: �y� � � CONTRACTOR EMAIL: t��EL7�tC,s'.�-yL�/oC6 u �� <br /> CONTRACTOR LIC.#(REQUIRED): ouJ�F $�f2 CITY OF EVERE7T BUSINESS LIC.#( QUIRED� <br /> PR!l�A�Y r�N7A�T: I_,I n�n�NF� �n�ry�rrna I'�nrH�R�aip�se Sr���f�,, <br /> CONTACT NAME: CONTACT PHONE:��� �C f ��t�2 <br /> �/`�'�� �!�'�C CONTACT EMAIL: ��•��CSf�f/t�"yt1: G�r.4a�t,Ga <br /> .,,...- • • - <br /> s�vrtcL�ivicPdT,i r`'ibleliy��riiiy iiidi f iiave Ye&ti drit9�XarrdriEu ir�Ys d�iN7iCdiiOii i7riu Klrc7w ihd S&rl�e iu�d iiue&!iv G-v)r6Cf. ii�i�.iliiviSKln�ui iaw�tili�5�IF�iYIr]fiCbS y`�vBifii�)y iiii�iype <br /> of work will be complefed whether specified herein or not. The granting of a permit does nof presume to give authority to vrolate or cancel the provisions of any other state or <br /> loca!!aw regulating construction or the performance of construction. 7hat l am authorized by the owner oi this property to perform the work for which application is made and 1 <br /> comply with the State Contractors taw 98.27 RCW and 296.200 WAC. <br /> Cify of Everett Officiai Use On/y <br /> PERMIT# <br /> -�--� 2 �� ��7 � � �-� 2. -- 1c`� � <br /> OwneriAuthorized Agent 5ignature p e I <br /> (Revised 9/23/201 S) <br />