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LECTRICAL PER lT =ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-2578810 I FAX 425-257-8857 I (E)everetfeps@everetfwa.gov www.everetfwa.govlpermits <br /> 'f <br /> PROJECT ADDRESS: N.01 bath Der .,.,j <br /> BUILDING AREA(if residential,new construction,remodel,or addition) r¢ 9 SF <br /> BUILDING TYPE: El SFR-DETACHED El SFR-ATTACHED El DUPLEX El MULTI-FAMILY-#OF UNITS: EI COMMERCIAL <br /> USE OF BUILDING <br /> IELIEBsTRfiCAY.APPLUGAT➢O•N IINFORl4NA,T1OJte <br /> CONTRACT PRICE OF WORK:$ • <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES El NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): )t k': 0 "'"/ <br /> DESCRIPTION OF WORK: A) Y ) 1 k <br /> CCINTACT It+TFORMATtON '. <br /> OWNER NAME; -11)IA)(A/471 TENANT NAME(If Commercial): <br /> OWNER MAILING ADORES'S STREET <br /> • <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: flay-��%G'.._.n V; sTa. ....0�j....l�f��/ „12-,/,�' .. . �....., _,... ..� .s...,.�..,._.......,. �9..�. ....,�...F._ <br /> CONTRACTOR ADDRESS: sTREErS/ 2I1 4�?ib //��" ).,�' UJt ' �ij�j7 j <br /> ccryN/ 1 STATE 14)at l ZIP S 032 <br /> CONTRACTOR PHONE:tt 7, Cs (�."" ( 0 j CONTRACTOR EMAIL: ( <br /> CONTRACTOR LIC.#(REQUIRED) .rI ew>. \.rVyy B( .4 CITY OF EVERETI'BUSINESS LIC.#(REQUIRED) ��:l CY J s <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR U OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority fo 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 forwhlch application is made and I <br /> comply with the State Contractors Law 18.27RCINand 296.2001 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 50 co <br /> PERMIT <br /> e(ac-o b FLo.0 -(15 <br /> o r/Autlior zed Agent Signature hate (Revised 10/12/2015) <br />