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Al$091', ELECTRICAL PERMIT APPLICATION
<br /> - CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 vAmmeverettwagov/permits
<br /> ,:.',..,70,,i2,;.'41: '::•; 3`:‘::-,4?-.)toti4fitt041::!..1**.v :t0ii:***11:;,,,I).C,Iginif:affikigtMicIVI ii,: :-.;: -:k-'.,:.:.7;.7.,--,,'VIVA:
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<br /> PROJECTADDRESS: --gbCfs L.,) titslwit. 110, ,ff,:- - 'err, 1.4,14. C145•2M
<br /> BUILDING AREA(if residential,new construction,remodel,or addition)._ SF .,
<br /> BUILDING TYPE: 0 SFR-DETACHED .0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: rirCOMMERCIAL
<br /> USE OF BUILDING: ,K0,,,C*4 irialirit
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<br /> itg$*:;d0,1*:t;. 'VC-241,,,, --,:iw LEttititA tpi. 7 ''le AT 16,44V r i ittift li 11041AFf Of(:''•,.z1'4''''."s':“:r t''''' ',IN'''4''`Ni`''''''•''•' -
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<br /> CONTRACT PRICE OF WOR '. CIOA 0 0 a / --
<br /> NUMBER OF DEVICES (if low voltage): ,
<br /> FIRE ALARM? 0 YES IINO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable).:
<br /> DESCRIPTION OF WORK: AccocAere 64 zsrs-kir4 *CCIP1:441(5. afte aP 2 1 n77)1-5 .
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<br /> ..j.-CVAge..., ,11.";-„f,f'kPr ,:e,,':,,t;:>' . ,'...,•',' '‘:0,,,:7*-0,41ePit41444tAttlf40,ORMATION 0k!A'A'''',V*441.:f* •,a,t'''=.Z.'"'-`.e..,'::,..=,K.,:',4''',' `',,,,_ -- ...- k
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<br /> OWNER NAME; eati:E0•01441, TENANT NAME(If Commercial): q.(57 -1 r- 1-1. S
<br /> OWNER MAILING ADDRESS: , STREET (SD i) ) 4..... Srittb 1247
<br /> CklY ttfUjeerl: STATE OA' ZIP q no-S
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<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: Ple•147,04C 41 e-ez...17.2.z...c., 1
<br /> CONTRACTOR ADDRESS: STREET 133 6 1 C E 2-6.1'4 5
<br /> CITY ege,tlV " STATE IJ A (15-at ,
<br /> ZIP
<br /> CONTRACTORPHONE: a ,..S---7 14-7-Cart CONTRACTOR EMAIL: P(' ..irS Q is4.7414 Eel...cc...next.cor-if I
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<br /> CONTRACTOR LIC.#(RECIUIRED): log.ifr4cii3lt ri T CITY OF EVERETT BUSINESS LiC.if(REQUIRED): li1LJ4
<br /> PRIMARY CONTACT: 0 OWNER Er:CONTRACTOR 0 OTHER(Please Specify) :
<br /> CONTACT NAME: pl . ... Lt si,
<br /> X-Ipot a,* n CONTACT PHONE: ti;S„,....7q7-ss S
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<br /> CONTACT EMAIL: 4e, z - ,r et,Xpledt-Camde.Z.c . Ceitot ,
<br /> AGREEMENT:1 hereby certify that I have read and examined this application anti/mow the same to be true and correct. All provisions of laws and 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 to violate or cancel Me provisions of any other state or
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<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 end I
<br /> comply with the state Contractors Law 18.27 ROW end 296.200 WAG.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> ,...i.i... 7.- Ici- I T.
<br /> E\ / \\,0
<br /> Owner/. ithia" •:tit-Signature Date (Revised 9/23/2016)
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