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����� '���, ��� �� .����.������ <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982D9 <br /> (P)425-257-8810 � FAX 425-257-8857 1 (E)everetteps@everefitwa.gov� www.everettwa.gov/permits <br /> ,,... <br /> ;. . . . ,.... <br /> �, ,. <br /> ,. <br /> : ,_. <br /> , . P1tOJE�7' S�'TE !I?lFO9�AVIAT�OIe1. ` - <br /> PRQJECT ADDRESS: �y/O W• ���`O� <br /> BUILDING AREA(if residential,new construction,remodel, or addition) � � SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX L�VIULTI-FAMILY-#OF UNITS:� ❑COMMERCIAL <br /> USE OF BUILDING: �.s'WjFJ���4(,,-- /'i7tL �/y�/L ' <br /> _; , . � .. . : - - - <br /> . _ , <br /> ELECTRICAL APPL-,ICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ S�O -OO� ' <br /> NUMBER OF DEVICES(ifi low volfage): � �- <br /> FIRE ALARM? ❑YES 1�N0 <br /> ASSOCIATED BU(LD1NG PERMIT#(if applicable): /9- <br /> DESCRIPTION OF WORK: �A L.G/ �L � tlN�l7"#1 2 <br /> . �, _ , . .. . . .. . . . . , . .. . _. <br /> . :`: . CONTACT INFORMATION... :: <br /> OWNER NAME: 5(�/�i�l$� � ]�i`�)�J9�J�- IZ,� TENANT NAME(if Commercial): /�l <br /> OWNER MAILING ADDRESS: srReer /� (N- � /1� <br /> CIIY �V�'%/l STATE �T ` ZIP � y � <br /> OWNER PHONE: 7�NNIZ/�L MO�} OWNER EMAIL: � /'Y <br /> ... . �,. . . .. ... � _:.... .. „ .,.. . . . ., . �. �. .. ... . . . ....w,. �. <br /> CON7'RACTOR NAME: �IILS� G���..�C <br /> CONTRACTOR ADDRESS: s-rRe�- 01��� <br /> cirr UC.�-'=�— sra� � ziP g � <br /> CONTRACTOR PHONE:�Lr�6g� ��0,,� CONTRACTOR EMAIL:WII�HV�S�@ �'���C� <br /> CONTRACTOR LIC.#(REQUIRED}:,�R„r�TC��7��Z�% CITY OF EVERETT BUSINESS LIC.#(REG2UIRED?: Oyl�PO� <br /> PRIMARY CONTACT: uCl OWNER CONTRAGTOR L7 OTNER(Please Specify) <br /> CONTACT NAME: CONTACT PHONH: j�s=,2(g'—7�'�j <br /> � 5�r���/� CONTACT EMAIL: (�,jrP�Nt[`�'� 6 B /�A/�'J�`� <br /> AGREEMENT.-T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this <br /> iype of work will be completed whetherspecifred herein ornot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherstate or <br /> locallaw regulating construction or the performance of construction. That 1 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 98.27 RCW and 296.200 WAC. <br /> City of Evereft Otficial Use Only <br /> , FEE <br /> . � � oo- <br /> ' PERMIT# <br /> cc� ��b � ��' O J ' `J' \D <br /> Owne orize Agent ignature D te (Revised 90/92/2015) <br />