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#1/ 11•!---06.,,e—A ILECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT=SITE INFORMATION :` <br /> . <br /> PROJECT ADDRESS: ' .1-1"0 t �@��� �V ''L E:v'etre� 1 tinPA �4?)'2-0 _.. . <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: Q(..iFcC-6 <br /> ELECTRIC L APPLICATION•INFQRMATION <br /> CONTRACT PRICE OF WOR $ (a5 O. " <br /> • <br /> NUMBER OF DEVICES (if to voltage): <br /> FIRE ALARM? 0 YES )Q NO <br /> ASSOCIATED BUILDING PE- IT#(if a.• icable): <br /> DESCRIPTION OF WORK: A , (11 I t y\;4.," a,r�,�,- I i vt.sLLt (3 4--) c)-5-vvU y <br /> t h S l ( ) i✓� �� s� 4 i \ (i)J4-' tzb, 5�-�(' L`av iv�S�u� 0 6) 3o'v' LLQ <br /> CONTACT INFORMATION <br /> OWNER NAME: TCc,v e, TENANT NAME(If Commercial): i\\` <br /> OWNER MAILING ADDRESS: STREET Z C2jvv.\pl p,)j V\. J <br /> v. (�, / <br /> CITY �Z s p STATE " ZIP 9(S z,(O <br /> OWNER PHONE: ' S-10 ' fa-1 W2..- OWNER EMAIL: ovvv`-ems yvw,.,LQ , circ <br /> F <br /> CONTRACTOR NAME: S-Daka Spec.-k/ Z ems/ S fwevicef w1 C <br /> CONTRACTOR ADDRESS: STREET ,/9�y 3! R017.5 4/CC /Pa,41 <br /> CITY 4aei e nRf/ STATEE ZIP 47,. =, <br /> CONTRACTOR PHONE:ZO6`'/,17^3 y55 CONTRACTOR+NTEMAIL: NC.ifi 'Sov ►d� SSin C� /�/ <br /> CONTRACTOR LIC.#(REQUIRED):SOVfD 55 S'7467 CITY OF EVERETT BUSINESS LIC.#(REQUIRED 5,737/ <br /> PRIMARY CONTACT: ❑OWNER I5CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: i CONTACT PHONE: Zoto <br /> 'Q�..r'e �a\--Ve CONTACT EMAIL: DoL.,iy_., W co kA. 5c i ac, <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 I 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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 74//�- E ��oS -Owner/Authorized Agent Signa ure D (Revised 9/23/2016) <br />