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., - ELECTRICAL PERMIT Ajj LICATION <br /> I,,1►� CITY OF EVERETT PERMIT S/ICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everet(wa.gov/permits <br /> PROJECT ADDRESS: 3 # :&I , L't 1 TIMI A MIPMM <br /> BUILDING AREA(if residential,new construction,remodel,or addition) % SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 I DUPLEX r3 MULTI-FAMILY-#OF UNITS: - 0 COMMERCIAL <br /> USE OF BUILDING: 3N. ,l .1 MM1 <br /> CONTRACT PRICE OF WORK:$ 011 <br /> NUMBER OF DEVICES if low volta!e : <br /> FIRE ALARM? ❑YES. ONO <br /> ASSOCIATED BUILDING PERMIT# if a.'Doable : 6 -- S i <br /> DESCRIPTION OF WORK: i _ r i- i i '_ i lit a e1• INTIMInli <br /> WA .S `s— I L g► t • ' & _ I & ty tl '"6 INIti t�.tiI <br /> . t 1 . ri ' . % A EMI <br /> / iii,,-kei Tse . .k t .f ut a 'f , xtgc._ p. <br /> OWNER NAME: \ r U5 Yl j Vkc,ot, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smear c ilij 3Cleve,rti`YQ,•Q,vk W <br /> CnY 1�_.i�t Vr V T E Y J A ZIP Cr4 /l J R <br /> OWNER PHONE: 'Z,s '- '.-.\-1- (.Q¶LQ Cj OWNER EMAIL:\0012 4-Y ONIV\ OY*(a' irel.AS crylevItI,C <br /> CONTRACTOR NAME: S\pkein "tl`‘,#k['`bVNj 0 lk <br /> CONTRACTOR ADDRESS: STREET Pc so i, C <br /> Crrf `r\1\10-DA <br /> \t"O-DA STATE WA ZIP q�1jL(p <br /> t <br /> CONTRACTOR PHONE: ' t 1J D CONTRACTOR EMAIL. S l t We, •c-06 <br /> CONTRACTOR LIC.//REQUIRED):�' S Q c pb . CITY OF EVERETT BUST SS LIC.#(REQUIRED):)56119 <br /> PRIMARY CONTACT: ❑OWNER tilt CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 47 • 2,9Q° "zolte <br /> t V`/ CONTACT EMAIL: <br /> 1\, � �L2-, �2c� 0,0 pt-tc.tak.ot kowtS'o`o-tiron SWQ, CNA <br /> AGREEMENT.'I hereby certify that!have read and examined this application and know the same to be true and correct. All p talons 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!am authorized by the owner of this property to perforin the._ • .•-.-. • .•.-•_.A.-de and I <br /> comply with the State Contractors Law 18.27 RCW and 298.200 WAC. i ` <br /> ____ <br /> ,.,._______ <br /> • cia 'se Only <br /> PERMIT# <br /> NIa ILk) 1-1 i 11) [ct E ilo .. 66g <br /> Owner/Authorized A en SI nature Date (Revised <br /> g g 9/23/2016) <br />