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ELECTRICAL PERMIT API"LIICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 l (E) everetteps@everettwa.gov I www.everettwagov/permits <br /> ' • • - •: . ' , lin' M JECIR SITE illitIF*RMATION':?':; -. : . • : - : : - <br /> PROJECT ADDRESS: aC)C\ jt C.3,,Z\f\O %10 -1ERYQ..."\--\-" I\ -\ <br /> 1 BUILDING AREA(if residential,new construction,remodel,or addition) C.KANNININe1CNa. \tte • <br /> BUILDING TYPE: 0 SFR-DETACHED El SFR-ATTACHED 0 DUPLEX Cl MULTI-FAMILY-#OF UNITS: 40IVIIVIERCIAL <br /> USE OF BUILDING: <br /> '.. „ .... <br /> ALTNINNI4'Ofi.-A10.1 -1:"S:1;-::- .:."-:: 1-,'f,. <br /> CONTRACT PRICE OF WORK:$ \\C)04, <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? DYES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK:L.10 <br /> - <br /> . .. <br /> . . <br /> - ,--•:.:. - ,--- ,''-• • deAtrAtTliktoithitAtteiti '' :: : " •": ''''' ' -• :-'' 1 ' -• ' '-'':':!- <br /> OWNER NAME: 1bl:3 '-' \(NV)e). --\\it.A\-:. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET\b kOr) \, E, \-\4s, ss ,3--s-E soko\ A\ <br /> errY 4ilf\\Zi\. 5?..- STATE vir. ZIP qtook4 <br /> OWNER PHONE: ,.. _,,.. ,., , OWNER EMAIL: <br /> . . - .. .. ... . . ...-. - . . . .. . .. , ... . . . . . .. ....,. „ .. ... . . <br /> CONTRACTOR NAME: IS)„\ 14R) _.&\c_. tie. QSY\V(K.,-/c1C <br /> CONTRACTOR ADDRESS: STREET if. ‘42t\')1 Gtox.\\k.ie.._ <br /> CITY S...R.Y.. STATE 4 ZIP 00&iy <br /> CONTRACTOR PHONE:kla\ \Z1, CONTRACTOR EMAIL: (tRc\c„R..... 40..e...\;e..CC,,• <br /> ;CONTRACTOR LIC.NREQUIRED): \I fV4RISZ: k.h(Z. CITY 0.0 EKERETT!BUSINESS LIC.#(REQUIRED): cas%. le <br /> PRIMARY CONTACT: El OWNER ONTRACTOR 0 OTHER(Please Specify) <br /> • <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: (t\Rci:‘,e iii .,. x, „.„ <br /> .•„ne,\.ef\s,ke ... n x , <br /> AGREEMENT:Thereby certify that 1)).42Lq)read and examined this application and know the same to be tnre and coNct Al/provisions of la—w.;and ordinances governing this <br /> type of work wi//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 properly 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 /> Fly <br /> . 4 iamo <br /> PERMIT# <br /> E t10'7- e1 ' <br /> Ow - t, 'orized Agent Signature Date (Revised 10/12/2015) <br />