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c2/408.O4, .748? <br /> ELECTRICAL PERMIT APPLICATION <br /> ,,,:-....A• <br /> #1-ria. = CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 40 <br /> PROJECT ADDRESS: . ... }`/ ..� �GGti"�„ _ ,a:•. - ...:_.. .,// <br /> BUILDING AREA(if residential,new construction,remodel;or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED CI SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: NI COMMERCIAL <br /> USE OF BUILDING: j OE1IUG EVERETT- <br /> :°_° <br /> ORM TiOI� <br /> Yeo _ '.0 �# :,.` <br /> CONTRACT PRICE OF WORK:$ PI It DDD <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ID YES $J NO • <br /> ASSOCIATED BUILDING PERMIT#(If applicable):c , �/� n ' <br /> DESCRIPTION OF WORK: rlita L[,G�C' C,.e Lhx,a ,�� �jt <br /> ex evealieLdivizio <br /> -vo-. . <br /> (j, • • <br /> . • <br /> • . <br /> �.? _... - ,0O.1y72ACT.')1N>FORtUI:00.0. . . . .. .` . -. -... z.: . ;:,--; <br /> OWNER NAME: • 2 TENANT NAME(If Commercial): i,Lc/Jl.)6 <br /> OWNER MAILING ADDRESS: STREET R2 gpX J7o7 Q• f <br /> CITY .5EA TZ.�' STATE 111/,1L�g/z'/—221)7 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: /U6iP tt. .a.)57I.1J 7'IU/t--) <br /> CONTRACTOR ADDRESS: STREET Pty 6o 41, <br /> CIYmag 11_1E-0 aTATEViM" 2IP9g2t4 <br /> CONTRACTOR PHONE:426-2/4 4/44 CONTRACTOR EMAIL: k/ '/e./. H4mmEieN lG/k1/w/1r1 COin <br /> CONTRACTOR LIC.#(REQUIRED): GEAV '''7D Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED):0140 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-is b-6 54. <br /> • D6-10115 e..epol CONTACT EMAIL: DENNIS.e.AoL10 kIEWI r. 6041 <br /> AGREEMENT:T hereby 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 will be completed whether specified herein or not The granting of a permit does not presume to give authorityto violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I em 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 a. 012 <br /> PERMIT# <br /> _ ,/ / 7..0../7 E l '-b+ 17'r <br /> Owner u orfzed Agen Signature (Revised 10/12/2015) <br />