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<br /> ELECTRICAL PERMIT APPUUCATISN
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 f FAX 425-257-8857 I (E)everetteps@everetiwa.gov f vwww.everettwa.govlpernits
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<br /> PROJECT ADDRESS: •
<br /> ,v 3 �� f�F� L g—c73
<br /> BUILDING AREA(if residential,new construction,remodel,or ad n) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATI-ACHED ID DUPLEX It•1]MULTI-FAMILY-#OF UNITS: NI COMMERCIAL
<br /> USE OP HUILDlNG: �p 1�G EV 7T
<br /> w�;•, /��.w,.<..:.._.41;181R41
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<br /> CONTRACT PRICE OF WORK:$
<br /> a/, 5DD
<br /> NUMBER OF DEVICES(if low voltage):•
<br /> FIRE ALARM? ❑YES /l NO
<br /> ASSOCIATED BUILDING PERMIT#(if ap Iicable):
<br /> DESCRIPTION OF WORK: I 1A • / / // A , �%���`�✓^
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<br /> OWNER NAME: TENANT NAME(If Commercial): 'lft.),6
<br /> OWNER MAILING ADDRESS: s'rmar po an( 5707
<br /> CITY .50f777-8-- STATE WA- SFC/g/2q 2207
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: _gek)erP L.
<br /> CONTRACTOR ADDRESS: sTREEr Po $OX 41,
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<br /> coNTRAGTORPHONE:426-214.4744 CONTRACTOR EMAIL: k4i i• Htheo Ele,W CD/Y1
<br /> CONTRACTOR Lie.#(REQUIRED): agAi8g4, t D Z tl CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�U5 ^^�
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<br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) •
<br /> CONTACT NAME: �f p / CONTACT PHONE: Zo6-73 O.-65442D t•- •
<br /> JJrsi15 .&)Uv CONTACT EMAIL: DEKA/jSxd.g(}iv kik-VV q 1T. C_oM
<br /> AORFFMENT: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 ornat 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 construct/on. That!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 18.27RCWend 290200.WAG
<br /> City of Everett Official Use Only
<br /> FEE
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<br /> PERMIT#
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<br /> /i. .►. /�// of .. - , E i o -(q 7
<br /> Owner/Aut or zed Agen Signature Date (Revised 10/12/2015)
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