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477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 ORIGINAL <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (. � F y .��. 0e p} -yam.. <br /> 7,7f. '� maw ' . _m `'PNaurEm 0.• _ _ <br /> PROJECT ADDRESS: LO (.Q <br /> BUILDING AREA(if residential,new construction,remodel,or addition) I c-Cbi—f SF <br /> BUILDING TYPE: 0 SFR-DETACHED %SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> CONTRACT PRICE OF WORK: $ U,©0 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ,NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): /� <br /> DESCRIPTION OF WORK: a�� G ( V CCA i t C°1 —8c v 4s^` -- ji <br /> 4? a < riill ..��— <br /> 1 hsyk it <br /> 'aft i.i n ,,. m a .n <br /> aau.-moi€ 161,4 Wip 4,01114 �, P,, � ,Ti rug 1i' <br /> OWNER NAME: v\f TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ( e (.0 JZ C <br /> CITY `/� /A STATE 1"-)•-1\-- ZIP! 66203 <br /> OWNER PHONE: \' k OWNER EMAIL: ` , <br /> CONTRACTOR NAME: )V G0�^^^����//��n/-QA,-� <br /> CONTRACTOR ADDRESS: STREET t L A� /1 W_ /� },`� om <br /> CITY + M"l./ �/1 STATE V " V \ ZIP 9.)01-1-3 <br /> CONTRACTOR PHONE:L1 ` - I i..3 CONTRACTOR EMAIL: v" L 1 O <br /> CONTRACTOR LIC.#(REQUIRED): Ff r f 1 33 i M M CITY OF EVERETT BUSINESS LIC.#(REQUIRED):0 1 - t <br /> PRIMARY CONTACT: 0 OWNER - 'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Lilly- l_ t'3 ci <br /> 4/j , Cr{,(r\A W\t 2/ CONTACT EMAIL: y\ L° <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 to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That lam authorized by the owner of this property to perform the work for which application is made and I <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# <br /> r t ( 3 ° l iT E trt © -240 <br /> Owner/Aut - zed Agent Sign re Date (Revised 10/12/2015) <br />