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ELECTRM I L PERMIT A� 1'. A .,ATilON <br /> ,_;;- CITY OF EVERETT PERMIT SERVICES <br /> miliwy <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: R32,0 F (t:COCA i 57 (-J floor <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 5.—en SF ' <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> IUSE OF BUILDING: OcC, ..C_5 <br /> 'ELFC'i'ItI:CAL APPLICATION INFORMATION - - <br /> CONTRACT PRICE OF WORK:$ 7D 0 O <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? 0 YES *NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): (' <br /> DESCRIPTION OF WORK: "'(ev1/4.,s;�Sc` k i to flG Fac( d -�rx <br /> /170 Int- <br /> -,.:.,:i .:: :, , _:, , , . , , . CONTACT INFORMATION.`. . . - <br /> OWNER NAME: $t&()k ovvt44 p(A,0 TENANT NAME(If Commercial): ,,,,, <br /> OWNER MAILING ADDRESS: STREET 2..Yi.0 C C.. \-4{(VV icy.V 5 "ee,.. /� <br /> CITY ! e...r ,,.4 4 STATE �� ZIP 9603 <br /> OWNER PHONE: 72.� 763,., /000 OWNER EMAIL: .. , . ... . . . .. . . .. ..w . <br /> CONTRACTOR NAME: r I llA 1. -�J (l+C <br /> CONTRACTOR ADDRESS: sTREET ` /Q V /i/ /Tl 5-, f <br /> crlY /1</('l('X/C(�„C STATE / //'7' ZIP 04)3 <br /> CONTRACTOR PHONE: Lc _ 7 Jim 0702. CONTRACTOR EMAIL: lek. L+: Y�Y 4.'__1.1,/7114 Q,i&4t't... 0..e. <br /> CONTRACTOR LIC,#(REQUIRED):BRIVKg.Lbcovvve. CITY OF EVERETT BUSINESS LIC,#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR� ❑OTHER(Please Specify)m��xKryY,I�SYT~ry(W�Y6~�'�'^,.'��^'__«V^,�+Y^�.^.ry.Xev�.,n�~_.V.—...^,mf�_��_,�" <br /> CONTACT NAME: IN (n A` [ CONTACT PHONE: Lc'ZS 7'f 4 f(7© (._ <br /> tJ Y �l of CONTACT EMAIL: 0 b c A 1. a., X4"1 , k <br /> _ _ .G . tD <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 I 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 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4V1293 <br /> i / , / PERMIT# <br /> `tel . / ?-// 11 ` <br /> //-- 2. 7 n 1 1..-- <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />