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ECTRICAL PERMIT ,A LIGATION <br /> '4141 erg{ CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov J www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 51 L7, LoVY\`ociac Ave_ <br /> • <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 3 0`�b SF <br /> BUILDING TYPE:' SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> . USE OF BUILDING: '7w c§€._ - -cxXy\ AkA k i:ANU . <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ • <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ❑NO n <br /> ASSOCIATED BUILDING PERMIT#(if applicable): CI t0 Ov, ` ooZ.cb <br /> DESCRIPTION OF WORK: ' 1 ep c ►(tu ` cL rte1 W k.c <br /> \i M � h't4- v..TaitW1 1� " &V' J . <br /> . CONTACT INFORMATION. <br /> OWNER NAME: j14,4\A.,4( Lov\ a - t TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Li-`51"6. <br /> cm, av 0STATE (1J 4 ZIP Crt l...0=1-1 <br /> OWNER PHONE: Likj a3:L `7c <] OWNER EMAIL: yiv &\yYLC.�ot�K.-,,( pu ,(Ai cL_\. c o w-s <br /> CONTRACTOR NAME: J <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT:�'[S[OWNER y,rs❑CONTRACTOR~� N -- <br /> 0 OTHER(Please Specify) <br /> ��� ��..w.v.��P,.,..,.,M.LL.�...�_,.�.M~y'f`�G`s��*�'.'n Ys^_Yµy�` <br /> CONTACT NAME: CONTACT PHONE: 1,-/, 'S c95'2,a\X\\5 .-e.c CONTACT EMAIL: <br /> AGREEMENT.:T hereby certify th have read and examined this application and know the same to be true and correct AU 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 tam 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 Everett Official Use Only <br /> FEE <br /> ' PERMIT# <br /> 1 I \': __.c 5q5.-ri E e 0 — Del`i <br /> ow,erlAut ."''dA•- -ignaure Date (Revised 10/12/2015) <br />