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óECTRICAL PERMIT AP-' -CATION <br /> `rte jCITY 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 /> .,! . ., �#,af,4. 7 1G;�,�"??c> "`:i'+aC. 't. r Q"�' ':�` .:, .- Yi7,(4 x, �.`.j� <br /> W � ",' "}'%T` �;,s.-. 4,, <br /> 3 <br /> PROJECT ADDRESS: C• a .Q,/ k 3 IP • Lri,. • II <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 'Ti 3 Z-. SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED &DUPLEX * MULTI-FAMILY-#OF UNITS: Z 0 COMMERCIAL <br /> USE OF BUILDING: A k ., 1166i �� $ <br /> CONTRACT PRICE OF WORK:$ 1 O <br /> NUMBER OF DEVICES if low volta.e : <br /> FIRE ALARM? 0 YES 0 NO - <br /> ASSOCIATED BUILDING PERMIT# if a.•licable : 1♦ d ,f <br /> DESCRIPTION OF WORK: I' a _ — £ rlt, `i 4 �bt�►��� ` !M < I3 <br /> tl at & !4 ��_ 0 <br /> /. &' ! : —InS1—a,- 1 `(Wu) �E C► i s A'I• ' <br /> Ir loAr4/ <br /> £ r � FFk x� dx ;.'+ �,_ ,, • <br /> ,� <br /> g;r-§:j� 33 ` 7 :' '� s - � •Wt "'4' .;;;_ .:. §eve ::.�, �.`.:3 � <br /> OWNER NAME: <br /> OWNER MAILING ADDRESS: STREET L <br /> CITY .A .' STATE i ZIP V r <br /> OWNER PHONE: LI 2S - Uag a OWNER EMAIL: ra o 'th ►,fto, 1 • , 0 s:• •P a <br /> CONTRACTOR NAME: 1,4f � ��.T.a <br /> CONTRACTOR ADDRESS: STREET Pb <br /> STATE ZIP * r i <br /> CONTRACTOR PHONE: .0 i CONTRACTOR EMAIL: 11.V/ Ata e, it, C i i I/rM / <br /> CONTRACTOR UC.#REQUIRED: S STS - Oa. <br /> 1b CITY OF EVERETT BUS ESS LIC.#REQUIRED)3O <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: [•i•]: t_C•� <br /> Y a�.[•7:Iyi_ b —■ <br /> N 1 G O / CONTACT EMAIL: aY\ Vlw - 0 r • ,• <br /> AGREEMENT.:I hereby certify that/have read and examined this application and know the same to be true and correct. Al - visions 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 /> —j 2�1t„Q7,nt-� E 91i22- O(,7 <br /> ner/Authorized Agen Signature Date (Revised 9/23/2016) <br />