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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 f(E)everettepseeverettwa.gov I www.everettwa.gov/permits <br /> ANIMINIMY <br /> �r>R <br /> POJ 311 4f 1'4° <br /> PROJECT ADDRESS: log <br /> BUILDING AREA(If residential,new construction,reel,orad aon) SF <br /> BUILDING TYPE:X SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> l9 1 hep 4,.,k :i, t f #*0404) # F qx' <br /> 3 Kr... sx ae sa: , .E�. sL <br /> CONTRACT PRICE OF WORK: $ 2.5.0 .°° <br /> M <br /> NUMBER OF DEVICES.(tflow voltage); <br /> FIRE ALARM? <br /> ❑YES iti, 0 <br /> ASSOCIATED BUILDING PERMIT# if a .licable <br /> os ?!K•1. 'Yt3 ‘M itrtell ,:.1t4 <br /> 1,tic d z <br /> OWNER NAME: . h. )Co sc). TENANT NAME If Commeretel <br /> OWNER MAILING ADDRESS; STREET �. <br /> L w ytr41=I, Ate,..-gr _ <br /> °rrY. •T V"STATE. ZIP j[# <br /> OWNER PHONE:112,5 OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: <br /> STREET e -• <br /> CITY '1 - I <br /> STATE ZIP '�^" 111 <br /> qi31 <br /> .. � <br /> CONTRACTOR PHONE. Li & O0%—a CONTRACT EMAIL: ; f <br /> e a ITV.(*EVERETT BUSINESS LIC.#REQUIRED <•" <br /> PRIMARY CONTACT: 0 OWNERCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: �� <br /> CONTACT PHONE: .W• 5 95ei TT; <br /> I 0 • *I CONTACT EMAIL:: , . <br /> t ,1 c0 <br /> AGREEMENT:I hereby certify(hat t'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 stale or <br /> local law regulating construction or the performance of construction. That lam 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 WAC. <br /> City of Evsrett Offlclal Use Only <br /> PERMIT# <br /> d OP <br /> l TJ ./ v <br /> Owne � <br /> i4i1 'ori ecl:Agant Slgttatgre <br /> Date .:. <br /> (Revised 9/23/2018) <br />