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/pillp. :' LECTFadICAL PE r TAF' P-UCATiS[- <br /> r, CITY OF EVERETT PERMIT SERVICES <br /> __ 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> • .: , PROJECT SITE INFORM S.;TQ-N',:'. ..• <br /> PROJECT ADDRESS: ,3-4.7J, 13tz-0riD v fly '-re. )a a_ <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF . <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: El,COMMERCIAL <br /> USE OF BUILDING: C o hw‘6ec,cx (}f F kr-,_E <br /> ELECT9t1Ci4,i.APPUUCAT1ON i[NNF®RMATnQN <br /> - <br /> CONTRACT PRICE OF WORK:$ 25o. <br /> NUMBER OF DEVICES(if low voltage):• Ito <br /> FIRE ALARM? 0 YES i,NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ico PtAarOC-/poi flnv#S <br /> • <br /> ...:..:. . . <br /> ON A T INFORMATION. :. <br /> t,1 u-c '3O TENANT NAME(If <br /> ta <br /> OWNER NAME: b.^i.yi (, 0.6 Commercial): c-u i CowittiC i i w6 Se c_u 3 i oNS <br /> OWNER MAILING ADDRESS: STREET 3-q7(, 134. J D t-,/c,`t .'t E. 3 0% <br /> CI Y 12.N16..R.C-.'C.0 STATE VIP ZIP 9 2,7_0\ <br /> OWNER PHONE:LIt-5 ZiZ ZZio OWNER EMAIL: <br /> CONTRACTOR NAME: L,i N 6 tut— L E c-Il.I C. LLC. <br /> CONTRACTOR ADDRESS: STREEr 32 iv3kr• •M' SE <br /> CITY GV.--- .r 7 STATE w p ZIP 9 g�B <br /> CONTRACTOR PHONE: LIZS $tea 53(50 CONTRACTOR EMAIL: Vibe-_\,,tom r.p.lec.4(:c. c.a,Mc_rssk.net• <br /> CONTRACTOR LIC,#(REQUIRED):L AC-P,6.1„90 3' ) CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(?5 3'i4.Zi <br /> PRIMARY CONTACT: cig OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:, i�.z,s- 2346 - s(051.L <br /> CONTACT EMAIL: <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type 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!em authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RC W and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE - <br /> PERMIT# <br /> flD �� Zs <br /> Owner/4 <br /> wner/ ed Agent Signature Date (Revised 10/12/2015) <br />