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0000. LECTRICAL, PERMIT APPLICATION <br /> ,- ---- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 I (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: - ?v 5 nexr./)/ c r"e4. P orki pu 0 i <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 20,OW SF J • <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ,1 COMMERCIAL <br /> USE OF BUILDING: 0-C�l p <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ -'i 11-7 ,.�' <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES NINO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): N 0 <br /> DESCRIPTION OF WORK: L_i)Gt�77 AerrO Pit <br /> i(Tob2 e% ; <br /> CONTACT INFORMATION <br /> OWNER NAME: J/J 1C.. TENANT/NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ,,}vim_ C:t 0 PaVit, <br /> CITY STATE ZIP <br /> OWNER PHONE: Ik- 9114- C:7-79S ,. OWNER EMAIL: <br /> CONTRACTOR NAME: 1(c,bl S E/a.c ri-t C, LI-C - <br /> CONTRACTOR ADDRESS: STREET �/Z1 ES � /L/�T J1/ J� ^� <br /> CRY /� lA/i�l�',/f lc.__ STATE £ - , ZIP G-7/ <br /> CONTRACTOR PHONE: d ZC 737.-.3'33? CONTRACTOR EMAIL: b ),�(�1"r'I(, e ,o1 ) c.v., <br /> i <br /> CONTRACTOR LIC.#(REQUIRED): SIo 9 y 96A CITY OF EVERETT BUSINESS LIC.#(REQUIRED): a <br /> PRIMARY CONTACT: 0 OWNER IgCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4c77- X333 <br /> g J 1 LA(L,t - CONTACT EMAIL: <br /> AGREEMENT..T hereby certify that I 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 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 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 00 <br /> . 4. \ \ St) ---1 <br /> PERMIT# <br /> /a 0 17---/ ----/-7 E\ 2' ( <br /> Owner/Authorized Agent Signature Date (Revised 90/92/2095) <br />