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f-046-A4:7'---4ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-881.0 I FAX 425-257-8857 I(E)everetteps@everettwa.gov j wvvw.everettwa.gov/pernl.its <br /> ;_5 ':i. ; . sir. . �.ate? ;� .,ms s..•;,, - ® . � � 5,,, fKr.M• . .7a,''o.....a <br /> PROJECT ADDRESS: 11.430 , CeLScrvb -.44- 1 ,..),.., <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR- ACHED UPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> 'e ' Tai : 1 n' it x 1, <br /> �h F' f � <br /> CONTRACT PRICE OF WORK:$ „► illi. <br /> NUMBER OF DEVICES(if low voltag: <br /> FIRE ALARM? 0 YES #,NO <br /> ASSOCIATED BUILDING PERMIT#(if a. icable <br /> DESCRIPTION OF WORK: tr ' -# ---- + 41.00. e exn <br /> :7.1';'''.1;:: <br /> y••€r ''' '';1 <br /> t yamE <br /> OWNER NAME: ,,., '`i ;..{.4- TENANT NAME(If Commercial): V 1 °t <br /> OWNER MAILING ADDRESS: suet ? tom' ' . <br /> CITY ,. t om...•,i / oSTATE 61,- ZIP q gl. J <br /> 11,1 <br /> OWNER PHONE: 1,„ . . .-- } <br /> 1 `7 OWNER EMAIL: lecifrvi <br /> f <br /> CONTRACTOR NAME: ,S al'. , 15 -. <br /> CONTRACTOR ADDRESS: STREET <br /> ..,, a $� 1 STATE 4 z. .:14.) <br /> May' <br /> l <br /> it <br /> CONTRACTOR PHONE: Q -" -°- J CONTRACTOR EMAIL: no reist-yQ-bkoha (a ,/.. <br /> CONTRACTOR LIC.#(REQUIRED:}`''i "` hit 37 CITY OF EVERETT BUSINESS LIC #(REQUIRE► <br /> PRIMARY CONTACT: 0 OWNER S CONTRACTOR 0 OTHER'(Please Specify) <br /> i <br /> CONTACT NAM l: CONTACT PHONE: i Ir>�`. <br /> . <br /> f a . 1 . CONTACT EMAIL: ypt I ' .'; , ' , <br /> AGREEMENT:l hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws end ordinances governing this type <br /> of work will be completed.whether specified herein or not. The granting of a permit does not presume to give authority 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! <br /> comply with the State Contractors Law 18.27RCW and 298.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 0/6)6// EI t0 - 2- Z <br /> Owner/Authorized Agent S gnature Date (Revised 9/23/2016) . <br />