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/1106111 ILECTRICAL PERMIT AFIPLICI TION ,i4w - - CiTY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 J (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SiT INFORMATION'. PROJECT ADDRESS: kkke\4 $t 04.) p„`t BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 14 MULTI-FAMILY-#OF UNITS: (.0 0 COMMERCIAL USE OF BUILDING: V_•PS C c(. k1,,, (_ ELECTRICAL APPLICATION INFO• RMATION CONTRACT PRICE OF WORK:$ %o`O'O� NUMBER OF DEVICES(if low voltage):• FIRE ALARM? 0 YES Si NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: e 1p.c.e 1 vb Fc„-..c_ _,-.'s f [` t f ka.L`e - �e tC'0 1`<--'e CQQQk pp "" CONTACT:INFORMATION. - OWNER NAME: l!�'e,k S VNI\ \1\ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET' 4 41 4 gy'ea.rA WC' k_ nq v-e-tivk CITY \A/P STATE 7820 3 ZIP OWNER PHONE: 9` �(p LA ' ( J S 5- OWNER EMAIL: ��SYU�/\ ,v vO ' (Ow,„&4 c A2, CONTRACTOR NAME: P(r5'kr\ E-k.e-f-k-ri < CONTRACTOR ADDRESS: STREET (4*;6 s Jo rcA . uubil f1.610 N CITY Ut' ��- STATE z 3 ZIP y CONTRACTOR PHONE:42.g- U,e 53-9 ( CONTRACTOR EMAIL: ei L 1-1/1 tel S ' • -e,4. c � Cy/pi y/+'i 4e/.40,7 CONTRACTOR LIC.#(REQUIRED): )s \'Q.-x- 0g. Yo CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (S1\3 PRIMARY CONTACT: IrOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:`/'J U �� � \ qc \ cA CONTACT EMAIL: F 43(,(\N\s2 g j.01,N,C(},\,,l l\k, - 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 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 local law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC City of Everett Official Use Only FEE $.25 / - - 1/ PERMIT# � •� 2?71? E o - zo i Own /Authorize Agent Signature Date (Revised 10/12/2015)