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ELECTRICAL PERMIT AP (CATION <br /> 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 INFORMATION <br /> PROJECT ADDRESS: q 3 t Cot 19 AAre cv-e nekti kn.!A. 9 5201 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 72MOdQ t SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: k-1.00,- <br /> : <br /> -1Ov-y ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2.1 8 5 . Q0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ,/4 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Z.rAocLe.-1 C - bed h k'c; 1. <br /> CONTACT;INFORMATION <br /> OWNER NAME: 0(s TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET C[5 (++11p)1j ( /� <br /> crrY STATE IA/Pc ZIP 2-0 t <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: `/..2e-kr). <br /> CONTRACTOR ADDRESS: STREET [2(o2_0 3�`"- <br /> CJ <br /> CITY / VQ STATE f/`( zw �Jl l <br /> CONTRACTOR PHONE: 206 1152 .3200 CONTRACTOR EMAIL: 'tU2 (>Canne e c.40c0Vo-k-v . c <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER P CONTRACTOR 0 OTHER(Please Specify) 1 (0 02. L 1_2 q y\ <br /> CONTACT NAME: a/ 1 CONTACT PHONE: _2{)(0 82 ,r 3W0 1 <br /> 15 q 6-Q t 1I>, rvQs lIN-Q-C CONTACT EMAIL:c v q.Yte'�-e.r.,,2c Y\c le.a tvvv3 i -C,Z)v1r1 <br /> AGREEMENT:1 hereby certify that 1 have read and examined this application and know the same to\be true and correct. All provisions of laws and ordinances governing this type <br /> 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 I 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 18.27 RCW and 296.200 WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 0_5_11/76t)111011...' <br /> -m--� <br /> Ownerf u onz • ,e t S e R ( -:: � <br />