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-9z5-4/��9.oma . 303a, <br /> i- ELECTRICAL PERMIT APPLICAT!•N <br /> -- CITY OF EVERETT PERMIT SERVICES <br /> y 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 J (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> 71,x:. (g1 , 0 . � r�.>,11:0 iA°: oii� <br /> 1.. �'_ .....y.•..}.. ....J..,..s�.� . . '..:� ':i.[.:w•.i.,r'•,%�•:•: .,reyr.,ryy.4--iS'�. I..h••.... .V.�.l.. .Nt�u..l�:ni•f.:.iat-rs�lt::s.••: •r- ..... ... ...�..... . .. ....e �..)... f. i..Sv.l th <br /> PROJECT ADDRESS: ; 0 `' ,�:: iiy�� —Z", <br /> BUILDING AREA(if residential,new construction,remodel,or ddition) SF • <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX El MULTI-FAMILY-#OF UNITS: J COMMERCIAL <br /> USE OF BUILDING: Q 1' G EVE .E7-r • <br /> yci'a..Sr-, ,::r, 7.', _. „rL......t.�., ..a0l + W_ A _4:1i,ja . 0` 4R}� T t.'Sa`' .��-},Aza,� <br /> ...,cS.tux8r.:':t: n, „._t <br /> !' <br /> CONTRACT PRICE OF WORK:$ /81 Ofd© • <br /> NUMBER OF DEVICES(if low voltage):. <br /> FIRE ALARM? ❑YES A NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: r-' i J,Q z�j�j ' <br /> .ter z2./..4,"1 les2 • <br /> ...._.1. -"- ,.. L .. , . _:. .:: :.. .• <br /> i::•:: 401401041 O .._ . -m <br /> OWNER NAME: TENANT NAME(If Commercial): 17i1)6 <br /> OWNER MAILING ADDRESS: sittnEr /%? ,PDX .3707 . <br /> crrY b5gA7TLE STATE Wit 5Z /2q—2267 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: (2-geit)ee _ 6505772•Ue....TI0A3 <br /> CONTRACTOR ADDRESS: STREET Pa Box 44, / <br /> cny1nIA, IG7&C9 SWAMI/el- aPgg.2 4 <br /> CONTRACTOR PHONE:4262/4 7)" g 44 jCONTRACTOR EMAIL: k4-/e f, Mt/ME-4 kf will. e.cy <br /> CONTRACTOR LIC,#0REQUIRED): �El OTHER(Please Specify),,.__,/� e CITY OF EVERETT BUSINESS LIC,//REQUIRED):O4 5 <br /> PRIMARY CONTACT: ID OWNER 14 CONTRACTOR �� W <br /> CONTACT NAME: CONTACT PHONE: <br /> . Def�NtS �'�.b{�t/ - 204.-736-454-6v <br /> CONTACT EMAIL: DEAN rS.L ROCU d kik-vi/iT. &1Y) <br /> AGREEMENT:Thereby certify that t 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 l 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 ROW and 2S6.20d WAC <br /> City of Everett Official Use Only <br /> FEE 00 <br /> PERMIT# <br /> . <br /> ,/ / c73—e-•? /Y E aoa-(gS' <br /> Owner/Au orized Agan Signature Date (Revised 10/12/2015) <br /> . <br />