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101.1* EECTRICAL PERMIT AFIPLIC,*,TION <br /> *W1 - 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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: eit97/4 OZWV1440---715/ifilag‘ 620/ g.//`-P 14 .492( <br /> ..e ,,,,, , <br /> BUILDING AREA(if residential,new construction,remodel,or addition) _ /WO to, SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX li MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> .., <br /> ELECTRICAL APPLICATION INFORMATION <br /> G,V <br /> CONTRACT PRICE OF WORK:$ /2-00 -- <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? 0 YES (?)CgIO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): SZ)eay <br /> DESCRIPTI N OF WORK: pep?cerk <br /> Oz_ 1/1- e 62--a / c.,,, c4Yr alcy ,pei,/ °//d e4P,ea,, <br /> - _ - coNTAdT INFOAMATiON - <br /> OWNER NAME: yi,vif pot44, TENANT NAME(If Com ercial): <br /> OWNER MAILING ADDRES : sTs Coll ffox-97i7v. <br /> .......0egeice <br /> CITY itli STATE O1 9Z Z I P <br /> OWNER PHONE: OWNER EMAIL: <br /> . . ..,...7:„. / ,.. ... . . ,,.... .. . . . . .. . ,. . .. . .. _ . _, . .. .„ . <br /> CONTRACTOR NAME: „.S.WA lei) 'Z-Zeelle Z-1"C <br /> CONTRACTOR ADDRESS: STREET .9// /-_-ee-077 <br /> z„... <br /> , rfry,- STATE <br /> ( 96,AEg <br /> ic9 <br /> CONTRACTOR PHONE: **V,1 077"-(PA". CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED):ze sy-4409b-z_iflos CITY OF EVERETT BUSINESS LIC.#(REQUIRE ): (2514,CP <br /> PRIMARY CONTACT: 0 OWNER AkONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 0G. 66 /— VI 67 <br /> . Yi,u,elys P9afrq ct--( CONTACT EMAIL: 1 /4&/cgo oil, Co/1-7 <br /> AGREEMENT:T here0 certify th I have read and examined this application and know the same Wbe true n orre t. All provision 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 we authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> ..,----- <br /> _ <br /> PERMIT# <br /> La <br /> 'wow .__ _ /0 0 71- / E \ "409055 <br /> /Authorized •gen agrir"re - Date (Revised 10/12./2015) <br /> , <br /> ' <br />