|
/O 1 .. 427o ;56
<br /> ELECTRICAL PELT MIT APPLICATION
<br /> -- CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-267-8810 { FAX 425-257-8867 J (E)everetteps a@everettwa.gov J wwww.everettwa.gov/permits
<br /> ��'n'41•• `;�`. � •i 1. w.y -}. .Iv...t..� /�,y�. _ +gyp;}n.,.•,..,
<br /> .•f, ,r�• ;',•i•;. y-• T O� a6i-1i��1.ry�.-,�y,,�( .,.�. q.1-yr N�� 1::.....t.•a. •r•-� ..•T'•.:, r:._,..,r,:
<br /> �;�••.:.,e:b.b. :�r' r r�}R� _ r,pl.N .1� V�ISlpq '°r•' �_Y.r ...Fn rf
<br /> .. � ,��i,:..a.....». .. .... ..... ..... .. .... ....Yf..a.+z..�+'r+�trr r�`rn n,.:....,-_».:.v�.. �.a..r"'dF:. �ai.:�•. .� ...... ... ..:•'a.:.,'?,:hs..... •, �•+�.`
<br /> •e,.,•: �'': �•• r" :.:. ie. ;. '+r.r, +. sr-.r•1•.� - .•. .: ..fir y �..S.wi
<br /> PROJECT ADDRESS: •""i•, O .r etolit ete ', .11 'Vier,
<br /> BUILDING AREA(if residential,new construction,remodel,d'r addition) SF
<br /> BUILDING TYPE: D SFR-DETACHED D SFR ATTACHED El DUPLEX El MULTI-FAMILY-#OF UNITS: NI COMMERCIAL
<br /> USE OF BUILDING: ©� nt G EVgt E'T7 i
<br /> +;:C,S¢,i`s.f��;.�r,��m. •• a•�o•{.ro.-rtr• .+,. ,�... aK• ,—�.�• - •r•':.v.��.r,.:,r.Y'}}•,,••- •.n�.r•-nz:Yn;r .�zr:ti '
<br /> ,: '_' G •/.y.�Jf,�.L �j "�■y ��.e�1b� �ry`�Pn+QiVliq�TIO� �' 'y` :,..>;,i:•;^t: r•'
<br /> {:+.G�.. .'•`.rr.t.,.f.: . ., .,..,....'.•.::. ..::Y..i `�,�a•-x rM..,z .eta.3FCku,.Fyu..•uv.•��niV4f'.$•.•1,r+3�a.�.=+i+iJ aZ...R.. �•+...r.r..r.,.+.�_,'!,`'_..,:,:jt4i,:.:r.•}:'�.«:ae.ofL,l:�.:...,.6.is?y.•.z.::ll r.^LE�l'•
<br /> CONTRACT PRICE OF WORK:$ �j 4•00
<br /> NUMBER OF DEVICES(if low voltage);
<br /> FIRE ALARM? El YES NO
<br /> ASSOCIATED BUILDING PERMIT f#(If applicable):
<br /> DESCRIPTION OF WORK: 7, t1y 1/y
<br /> ^N- t X•a ru`! '.e+ fi .. "6F' t..�..l l+r.�-pr, Jl� y ..
<br /> .
<br /> ••
<br /> •
<br /> •
<br /> <:r. , • __ . Y': GQhlT401N0144411014
<br /> . ,. . ..<:
<br /> OWNER NAME: TENANT NAME(If Commercial): 1j1}6
<br /> OWNER MAILING ADDRESS: smxeer Pa 60x 3707
<br /> CM' .5Ej "'(rte - STATE IA/ / ZfF 1$/2 2207
<br /> OWNER PHONE: OWNER EMAIL:
<br /> .r. .y ... n -,�. a .... , .M . :. ,,.... ...w r. a. . rr ..r i. ➢ .,. i .. .. . w .,,. +rv... r.. ... �.
<br /> CONTRACTOR NAME: �. ivi✓,P _
<br /> CONTRACTOR ADDRESS: mem'yyPaeax 4( ,t /
<br /> crw Ina /t- � STATAiVM zip9g2a l
<br /> CONTRACTOR PHONE:426-2194 4/44 CONTRACTOR EMAIL: ki+,e f. kilt/IAEA&k/ �(j/'/T. Log)
<br /> CONTRACTOR LIC. REQUIRED: GgAi C "r7rOz CITY OF EVERETT ElUS1NESS L1C.f#(REcIUIaED):0210
<br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR D OTHER(Please Specify)
<br /> CONTACT NAME: p CONTACT PHONE: 2 2 '-73e:7-6544 •
<br /> I��f lJ I t S 641,(/t) CONTACT EMAIL: DEN/ is.6AO4.I® kIn}nv T. LLAM
<br /> AGREEMENT T hereby certify that I have read and examined this application and know the same to be true and correct Ali provisions of laws and ordinances governing this
<br /> type of work wllibe completed Whetherspedfred herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state a
<br /> local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perforin the work for which application is made and 1 J
<br /> comply with the State Contractors Law 18.27 RCWand 296.20d WAG
<br /> City of Everett Official Use Only
<br /> FEE
<br /> •
<br /> 69
<br /> PERMIT#
<br /> OLN
<br /> / r' 9
<br /> . El
<br /> Owner/Au or zed Agen Signature Date (Revised 10/12/2016)
<br /> ••
<br /> •
<br />
|