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litECTRICAL PERMIT AFRILICATION <br /> 1�►� 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: a WeT ( . ,'/ - 3 <br /> BUILDING AREA(if re 'dental,new construction,remodel,or addition) SF <br /> BUILDING TYPE: -DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-it OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: V<.' 'f 1 l 1 1. <br /> ELECTRICALAPPLICATION INFORMATION: :`. :: ;=::.: <br /> CONTRACT PRICE OF WORK:$ ,Q V <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Vit (2.-k \L\ OF D6TA-t_A-Y '-) EVI9J4kbi C/ I 2J n(� <br /> :;CONTACT INFORMATION.- <br /> OWNER NAME: SP.rC,NrC" �1,�2Cc 2.,. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 5.10 \AI. 0{Z. <br /> CITY I y V T�r/�r STATE WA- ZIIPG'J <br /> OWNER PHONE: LW-501-'11-4D Q OWNER EMAIL: St' Imo► > C rte,- <br /> (l 3 <br /> `2 <br /> CONTRACTOR NAME: �'�.�,C� Y"` <br /> CONTRACTOR ADDRESS: STREET \ C, 1 <br /> � <br /> ((a <br /> CRY \STATE LJ ZIPO � <br /> � D <br /> `�t <br /> CONTRACTOR PHONE: 17531.- ( CONTRACTOR EMAIL:itD0A. (' S&U4cJ l D "��)'C.-1251171 <br /> CONTRACTOR LIC.#(REQUIRED): VM A tQ It-LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): t 14 <br /> PRIMARY CONTACT: ❑OWNER , G�INTRACTOR 0 OTHER(Please Specify)e� <br /> CON ACT NAME:_ + 1 ��� CONTACT PHONE: �-� U.-,- 3a']-�L021 <br /> ( L,ULI1 L-{L- CONTACT EMAIL: C S M \ <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!am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC <br /> City of Everett Official Use Only <br /> FEE <br /> I 060 <br /> tot <br /> PERMIT# <br /> E i865-03 <br />