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31.23
<br /> ELECTRICAL PES' r SIT 7kPPUUC,•STI IN
<br /> o,-•- CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERE I I,WA 98201
<br /> (P)425-257-8810 j FAX 425-257-8857 (E)everetteps@everettwagov I www.evereftwa.gov/permits
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<br /> PROJECT ADDRESS: .9v-c04 ...... ......_a..- ..._ .. .. i.._ ";.t.
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<br /> BUILDING AREA(If residential,new construction, model,or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED ID SFR-ATTACHED 0 DUPLEX 4 MULTI-FAMILY••#OF UNITS_ pi COMMERCIAL
<br /> USE OF BUILDING: OE/l4l� EV _En-
<br /> :_aCi.:-,:'t'•.�:,V�s s...,.. ::,1..,... ....._-. :.:3j..v 4c��tte::eW.a':C:u.....an.....i,..r�,`x-T'��gval•"..:r4. ....,.•t.x+,..•:.as.,.yy.�3:. .,....::.GL•r2::iE.::'._,'ye;:9t:h 1.:.-7..na>`b'�•s x.a�iti(.L�.
<br /> CONTRACT PRICE OF WORK:$ 000 •
<br /> NUMBER OF DEVICES(if low Voltage),
<br /> FIRE ALARM? El YES PI NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: P /17194U 09/5, -1 1/f job
<br /> •
<br /> ' •. •. . .�. ;= • GOTACT:INIF�R111A'1`xON:' •
<br /> OWNER NAME: TENANT NAME(If Commercial): -A.)6
<br /> OWNER MAILING ADDRESS: STREET pa 60)( 3707 •
<br /> crrr :5 i rT'LE STATE 1A/4- 2IR /22 2207
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: � iVjetz 69Pa g2U /70A..-
<br /> CONTRACTOR ADDRESS: STREET Pi e2X 4/, '
<br /> cnY mom STATEV, - 9g204
<br /> CONTRACTOR PHONE:426'2,94-4,944 CONTRACTOR EMAIL: k4lCf. 1-betholE~t4
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<br /> CONTRACTOR LIC.#(REQUIRED): L��/V�� �/1G���O z CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O4o5)
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<br /> PRIMARY CONTACT: ©OWNER EI CONTRACTOR CI OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 20k- --65j/-k
<br /> E EN 1 S 6401l1l CONTACT EMAIL: D N 199.6A0Lt)(tom kik-wt 1 T. d.0
<br /> AGREEMENT:Thereby certify that I have read end examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
<br /> type of work witlbe 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 1 am authorized by the owner of this property to perform the work for which application Is made end 1
<br /> comply with the State Contractors Law 18.27 RCW and 29620d WAC.
<br /> City ofEverett Offialel Use Only
<br /> FEE/
<br /> PERMIT#Q�
<br /> Owner/Au i or zed Agee Signature Date (Revised 10/12/2016)
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