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•LECTCI1\L PERI !11T 43LICATIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ] FAX 425-257-8857 ] (E) everetteps@everettvva.gov] www.everettwa.gov/permits <br /> J PROJECT SITE >INFORMATIO➢lB <br /> PROJECT ADDRESS: S I k- (r14y <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> d;LECTRICAL APPLICATI®N IIR9F®RihAT10N <br /> CONTRACT PRICE OF WORK:$ .2,5V-•d D <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: tivyrktil 0 vdr s"6 ri CV> rKuitelfey i�I,✓' Z .9(14. <br /> rJi`� t l z')64S/i, 5(/i✓0714-0/ 6341VicwS J7(A) <br /> CONTACT INFORMATION; • • •• • - <br /> ()INNER NAME: 7446r7- TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: tiOdiV4 sl�N etvirevitkiii <br /> CONTRACTOR ADDRESS: STREET f 25-5 W&>i/410. / <br /> CITY .544.&GCSTATE ZIP ?f"0r <br /> CONTRACTOR PHONE: ��G 237z-07w CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): /41/0.SC43lry CITY OF EVERETT BUSINESS LIC #(REQUIRED): Y� <br /> PRIMARY CONTACT: 0 OWNER ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Zr61- Y,j0 Z875-1I <br /> s��✓ Z, off' tid CONTACT EMAIL: 5+lve Z d 01.7'i;,1 lsifn 6,'fp• C� <br /> AGREEMENT:T hereby certify that I 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 tam authorized by the owner of this property to perform the work for which application is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT#gat3.3 b <br /> Owner/AutFiorizedA,entSgn re Date (Revised 10/12/2015) <br />