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ELtCTRICAL PERMIT APPATION <br /> I�►�f, CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> at�{�<t -.����; '�.:-,'� .. .. - - rc �: � �� .. p Cif:. aa -;. <br /> —10 <br /> PROJECT ADDRESS: 3.2X)UV 1 ;, )1111;Wilgolli.1.4=11 <br /> 6 <br /> BUILDING AREA(if residential, new construction,remodel,or addition)_ az., SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED ❑ DUPLEX f MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: At j E,i r •a 1L <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES if low volta•e : <br /> FIRE ALARM? 0 YES a NO <br /> ASSOCIATED BUILDING PERMIT# if a••licable : _ <br /> DESCRIPTION OF WORK: 't_I •' I 1 i �" �= E /j • to ',ME <br /> � � . ." � ���., k�> �,.5'. _ i � ' �.,.,s ..r--:. %`s'^, • . .. .,. ..., :'... . .. ��n c'.. iYi`k � �n,.y.h A.r. �. .r„ "'.s'.�F�"u..:'Y;�"iiK.. .k.,.,, <br /> OWNER NAME: IMr1Za ILI i` TENANT NAME(If Commercial : <br /> OWNER MAILING ADDRESS: STREET • 1j 1' ► A P <br /> CITY #_41111 STATE r Y ZIP AM <br /> IE <br /> OWNER PHONE: 1? �► i OWNER EMAIL: 41, y I , f,/ J/) I/ ; /f L f. , . r_ <br /> CONTRACTOR NAME: +y �� d 0 • <br /> CONTRACTOR ADDRESS: STREET AIL 11111111111111111111 <br /> A, <br /> CITY J a AVN • W STATE WA ZIP s� r, <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED):S"I STC Wq1 Y CITY OF EVERETT BUSINESS LIC.#(REQUIRED): i g <br /> PRIMARY CONTACT: 0 OWNER ( YCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: [d•l.tt►c�•��J.I•Ll �►_ i rt 2 j3 <br /> �$ ' '/ Yv CONTACT EMAIL: _♦ �! 1 i S ;� <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. Al!pro ' ions 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 tam authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> )\(Ctek ONA/V•...d 2-11 b.+ E r7oa - o (07 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />