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ELECTRICAL PERMIT .ATI-I*LIICATIION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ] FAX 425-257-8857 j (E) everetteps@everettwa.gov] www.everettwa.gov/permits <br /> y�1� pIECT SIITJ NF t� 7 T - - <br /> . . - 1F"It�lOc9 01. i:d7IITE:11:N 1! O li .:_'i L=�1 0 14:pC+i�r' _ - <br /> PROJECT ADDRESS: It ZU (S Cc(>Y Wde r/Id% 1. ,J <br /> BUILDING AREA(if residential,new construction,remodel, or addition) ft-PLC-kVA. SF <br /> BUILDING TYPE: 0 SFR-DETACHED y ��❑SFR-ATTACHED 0 DUPLEX C.,MULTI-FAMILY-#OF UNITS: 1:1 COMMERCIAL <br /> USE OF BUILDING: COP\041) _ <br /> CONTRACT PRICE OF WORK:$ i 5)0 , / <br /> NUMBER OF DEVICES(if low voltage):• 6* <br /> FIRE ALARM? 'YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 0747,%et ` <br /> re/1114-4 f-r/t` s'etiki , <br /> CONTACT INFORMATIION <br /> OWNER NAME: MP."PAZ ,SQ WANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /SS�I��� [� elf cc-re-2.e.O <br /> 9 r ��QJJ����CIITY q 1^ i /STATE (A/4 ZIP VMS) <br /> OWNER PHONE: $6� UIloL d f OWNER EMAIL:d7/& Y rD1I!� ...cd -�. <br /> CONTRACTOR NAME: All W(J • <br /> CONTRACTOR ADDRESS: STREET 'Oq 5W- h- 5'tI ///� /,!/n��r <br /> CIN e3e4 STATE Yt//e ZIP�q,L�s(� h <br /> CONTRACTOR PHONE: Z� • ('5S. (p/0--19 CONTRACTOR EMAIL: ye,, q/t4-i ...aee-) ('_- •'« " <br /> CONTRACTOR LIC.#(REQUIRED): /4 �� W. ql ,, ! /� CITY OF EVERETT BUSINESS LIC.#(REQUIRED):D,-4HD <br /> _ __ _,. •. . .. •_v . �...:n.�..w ._.-K!/.,'f..n_ a>.a. 1�(t1 4!� <br /> PRIMARY CONTACT: El OWNER tkr6ONTRACTOR 0 OTHER(Please Specify) <br /> C TACT NAME: CONTACT PHONE: L17j5 , ,..c- 0. _l3- P <br /> CONTACT EMAIL: G• ' <br /> `�- ' Sof� �l�/�'e e��� <br /> AGREEMENT:T hereby certify that 1 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 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 perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 295.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4514)-4 _____- <br /> y PERMIT# <br /> 1 i _____' f 9,,f// i <br /> / <br /> fo/ I'1 Dq '86 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2095) <br /> 11 <br />