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ELECTRICAL PERMIT APICATION <br /> CITY OF EVERETT PERMIT SE ES <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 /> ^: 5.":'4, _� � riv yam, .: <br /> PROJECT ADDRESS: 3N�t--tor /vb. ,D <br /> BUILDING AREA(if residential,n construction,remodel,or addition) 6vro SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED (IA DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: LreAve , rconl <br /> CONTRACT PRICE OF WORK:$ con <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): a Z. -~ a <br /> DESCRIPTION OF WORK: �l O(�`�-�-1;' [' ��(` <br /> 1'�-'1� HCl. C� , o a -�c -� wo�41 <br /> c\VV, cfl wl\ V v� C,re A- - ho - <br /> n <br /> -uon A,% 3' <br /> � -' . *-fix. y #,5?�'tE7 <br /> OWNER NAME: = s <br /> OWNER MAILING ADDRESS: -EET ata 6J <br /> ' }} cm' - 1":;, STATE � zip 1,8 aB <br /> "'1 <br /> OWNER PHONE: OWNER EMAIL: ♦• 1�1it�IN I , ►, <br /> CONTRACTOR NAME: A t ik _ b & <br /> CONTRACTOR ADDRESS: STREET 0 t* 1111M1111 111111111111.111111111111111.1.1111111M, <br /> CONTRACTOR PHONE: Z- • '!1U CONTRACTOR EMAIL: Z I . M I►rt .11 r.1�iA1�� (JL <br /> eblv- <br /> CONTRACTOR LIC. REQUIRED a IIICITY OF EVERETT BUSINE C. EQ <br /> #(R i� <br /> UIRED <br /> PRIMARY CONTACT: 0 OWNER tri CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: I.f.a , .t1G‘ a 01 V <br /> 1\1\ C Q t ' wAJ CONTACT EMAIL: Amu/iv% `� 14.1t, 1 <br /> AGREEMENT:f hereby certify that I have read and examined this application and know the same to be true and correct. .rovisions 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 l 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 /> /2-1A4 �c <br /> City of Everett Official Use Only <br /> PERMIT# <br /> N ee,ct .. 1_11tolj E t `To ; - (2 - 0 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />