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10217.S.2.11(4., bg L.1 -78)
<br /> ELECTRICAL PE f';MIT APPLICATION
<br /> ' CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERET•, WA 98201
<br /> (P)4425257-8890 j FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.govlpermits
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<br /> PROJECT ADDRESS: 0. %1 -. .J; ( { b"1 cot k= J�,
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED El SFR-ATTACHED ❑DUPLEX El MULTI-FAMILY-#OF UNITS: PI COMMERCIAL
<br /> USE OF BUILDING: OEJ�G �t��j�.c t 1
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<br /> CONTRACT PRICE OF WORK:$ 14) ,?-.A 5
<br /> NUMBER OF DEVICES(if low voltage):•
<br /> FIRE ALARM? ❑YES KI NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): y
<br /> DESCRIPTION OF WORK: z�1` ' - %'�cw...'�, Ce- .`e• ' lt.-...,t-e..5
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<br /> OWNER NAME: TENANT NAME(If Commercial): Jei;.e:/[J6
<br /> OWNER MAILING ADDRESS: miser /%7 &7)( 3707
<br /> are ,5TLL_ STATE tr p'7 /241-22'7
<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: ('. � erit, Jj.)5 /-U(,fr/()A.-�
<br /> CONTRACTOR ADDRESS: sinner Pe2 361,X 44
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<br /> CONTRACTOR PHONE:426-2/4-6/44 CONTRACTOR EMAIL: kA-ei. 1H4 iiYiEi_Je k/ W/1- eD/Y1
<br /> CONTRACTOR LIC.#(REQUIRED): 6EAleeq.c.it4o CITY OF EVERETT EIUSIN.ESS LIC. REQUIRED):O1Or} M
<br /> PRIMARY CONTACT: ID OWNER Ili CONTRACTOR 0 OTHER(Please Specify) •
<br /> CONTACT NAME: 'CONTACT PHONE: 204,-73 6-4 S 4-Lp
<br /> pjJJ!4 j S 6e00/ CONTACT EMAIL- DEN 4 j S.LL f•4L(1 o k'i "W 1 T. dAIY)
<br /> AGREEMENT:Thereby certify that 1 have read and examined this application and know the same to be hue andcorrect Ali provisions of laws and ordinances governing this
<br /> type of work will he completed whetherspeclfted herein or not. The granting of a permit does not presume to gate authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That 1 em authorized by the owner of this property to perform the work for which application is made and l
<br /> comply with the State Contractors Law 18.27RCW and 296.200 WAG.
<br /> City ofEverett Otf>c/al Use Only
<br /> FEE
<br /> PERMIT##
<br /> 6-q- 6 E INQ-®L1
<br /> Owner/Au or zed Agen Signature Date (Revised 10/122015)
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