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LLECTRCAL PERMIT 1 JCAT ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 j (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> r'R®EJECT:SITE8NF`0 ''MA`iP!(�Q. ,_.. <br /> PROJECT ADDRESS: Pctr(�C p1.. �i�' 1JNYe-77 1 2.2.5 Lit-)1 (1.40{‘ dCL <br /> BUILDING AREA(if residential,new construction,remodel, or addition) 14 J SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX EI MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> EL=OT 'ECAC APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:4, /0 0 O <br /> NUMBER OF DEVICES(if low •Itage): <br /> FIRE ALARM? 0 YES I <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 7 (.vIO !.i"' c-e i lo 497 4 Y"u o «C <br /> a o v / OT L,f)c 7t'1- 7ct 1,1 t' ) R a'7 47 0 c17L e�7 <br /> -; -� CON'i`ACT-INFORMATION. : : <br /> OWNER NAME: 5 Te U^e TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET L ). 1 W r C q( J I/J O iqo1-- s <br /> cmV` <br /> r e Y e 7 L/^7 STATE 1, / ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: CO J4- /- T Cj y1 )/ Et ec7•r G 1 e(C <br /> pr <br /> CONTRACTOR ADDRESS: STREET y ( £_C t� t' t.eI �►G( / <br /> CITY �✓{.) J /�j'( 70 X[i STATE w ZIP �f <br /> CONTRACTOR PHONE: el25'-2 G3 v 2� CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQQUIREED): I:V J( L S �,�:f 63 CITY OF EVERETT BUSINESS LIC.#(REQUI E <br /> PRIMRYACONTACT: LI<112 NER 0 CONTRACTOR CI OTHER(Please Specify) Y YN!_�.., _. _ <br /> CONTACT NAME: CONTACT PHONE: `12 2.73 2 <br /> CONTACT EMAIL: C p 141l.,71.04;7> et.ec7 rr <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All Avisions 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAG <br /> City of Everett Official Use Only <br /> FEE <br /> qz sr) <br /> e, <br /> PERMIT# <br /> 'gne() <br /> ,,,,z„ <br /> 9:—Zg-17 E nf39 <br /> er/Authorized Agent Signature Date (Revised 90/12/2015 <br /> ) <br />