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E�:ECTR�CAL PERMIT APPL�CATIO.�
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P}425-257-8810 � FAX 425-257-$857 � (E}everetteps@everettwa.gov� www.everettwa.gov/permits
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<br /> F�Itl����TADDRESS;_. ��Z� G ;E�CZ.��r _ _
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<br /> �iUIL,pIN�AREA��residential,new construction,remodel,or addition} ��
<br /> �3UILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED ,C? pUPL�X ❑MU�TI-FAMILY-,#„OF U�IIT�:: ❑COMMERCIAL
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<br /> U��OF BUILDING't ' -
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<br /> G�?I+�'Tf�2At��'PRICE OF WORK:a , :; �O _
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<br /> NUMBER OF DEVIGES fif lowtt�l. : 8�
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<br /> fIRE ALARM� ❑YES ❑NO
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<br /> A��C��i��'�'ED BUI�DIN��PERMIT.,# �� .� _,��ble ;; ,- � � � �� �
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<br /> DESCRIRTION OF WORK:
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<br /> OWNER NAME L ` �,���� T�NANT NAME t�C.ommercial�; .
<br /> OWNER MAI,LING AQ.QRESS: srReEr . ;' �� "- '�r- ;� °, : _ '
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<br /> WNERPHONE: � *�,,). �R I) 3Z- QWNER,:EMAIL. _
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<br /> �t�N?RACTOR NAMEc;: � `
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<br /> ��lNT-RACTOR ADDRESS: srReer
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<br /> �ONTRACTOR PHONE ;- CONTRAC70R EMAIL: � !`�` ; " ' ;ryt
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<br /> Gfl.t�l'�`tt�t�TB�f,�UC. FtE3�t�t�3�i3��;� " : ; : �Il CITY OF EVERE'fT_BUSIN.E...SS LIC,'�REtIU��t3 r , : .. , . ;
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<br /> PR,��l0.�lf`CONTACT: ❑OWNER
<br /> = CONTRACTOR ❑QTHER(Please Specify) _ '
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<br /> �it�lV''�ACT NAME: . CONTACT PHONE ..: +''�� �.C�� Z���
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<br /> AGREEMENT.•i hereby ceRify fhat i have resd and exemined this app/ication and know ihe same to be true and comect,A!i provislons of laws and ordlnences goveming lhis type
<br /> oi work w1U be completed whether speclfied herein or not. The granttng o1 e permlt does not presume to glve authodfy to vio/ate or cancel the provisions of any other sfata or
<br /> loca!!aw regulating conshucNon or the per(ormance of construction. That!am authorized dy the owner of fhls property to pe�form the work for which appikation is made end t
<br /> compiy wlfh the State Contractors!aw 18.27 RCW and 296.200 WAC.
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<br /> Ci�y of Fverett O�cia!Use Only
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<br /> PERMIT#
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<br /> OwhorlAuthorEzed Agent 5fgnature" " DaEe � (Revised 9/23/2OiG) `
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