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321,3 <br /> ELECTRICAL PERMIT APP ICATJ(•N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ( FAX 428-257-8857 ( (E)everetteps@everettvve.gov j vwww.everettwa.gov/permits <br /> �.`t.;`'•".•. •..i. :N:• r-�y:: ..i,<... .:..;n fsiwlIij +y.- ttp� a.o.t.^M+4■ti 1.�., .{;s� .-r. �.r,., ,. „}r•s-:•::-...;,�.r, <br /> t... .-...�:..ar:r..3. v.l±iei. <br /> PROJECT ADDRESS: -e---/e9 +GJ' t 01-S __--- — <br /> BUILDING AREA(If residential new construction,remodel'or addition SF <br /> BUILDING TYPE: El SFR-DETACHED El SFR ATTACHED 0 DUPLEX b MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: <br /> ;trf5`,,i`•iF ,p�,; - ,••,t.��., �: : � X JCIRIVI'.,'1'YO �..� r , :i - r -�;s cr F <br /> .ca.i.,,..4'.•5ii,5.x:<......+it,ra.:.....,Y.�:: :.�7:•:im.�,L�ean.. �sV�..,:w:., sa...n;=.•r•�•l;�Li�x-7arars•u.. _cC-rei.rc.4op.r+.Irv...e,Cl•n.J,:.+...•...:a�'.:ne .n�....:i...rf{zr�PS�•.+"..ie`Y:•, .t i,;.•{� <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? El YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: -d`/ P/2) � GL/ <br /> 97,,a4.4711 • <br /> • <br /> • <br /> • <br /> - . . .COIiI TACTINFOR" ATIIOo:— <br /> OWNER NAME: TENANT NAME(If Commercial): 7,10(o <br /> OWNER MAILING ADDRESS: STRssr po Eiox 3717 7/�7 <br /> cm, .5E}[-TT'LE STATE •�/� V r /22/ 22'^`! <br /> OWNER PHONE: OWNER EMAIL: <br /> ru Y4 .• ... r.. r .r e r T. •n ..-. • r , .r^. ...... . .r.,x.- <. . . •• e ... r e. .. r . y.� +✓4 r, ... r.. w , <br /> wr <br /> CONTRACTOR NAME: (i ,V1 ea.),5 W(.1/a/0 <br /> CONTRACTOR ADDRESS: STREET Pa /3OX 449 <br /> cn' ink Jt.7 2 STAm 4111 zip gg2,0 <br /> 1/1 <br /> CONTRACTOR PHONE:426'214-6944 CONTRACTOR EMAIL: ki- f. H V/E-g )kl W/7', CD/Y} <br /> CONTRACTQR LIC. ORE ��� � Q z CLTY OF EVERETT 18USINESS UC.#(REQUIRED): 05 <br /> PRIMARY CONTACT: 0 OWNER Ell CONTRACTOR 0 OTFIER(Please Specify)CONTACT NAME: p CONTACT PHONE: 2o�-73 -45/ e • <br /> . I��f 1�J4 J 5 6l.-•O ut/ CONTACT EMAIL: DEN)!S.Lt J�OL{ fV kik-W l T. dOfV1 <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct All provisions of law and ordinances governing this <br /> type of work wiitbe completed whetherspecltled 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 properly to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 ROW and 296.20d WAC <br /> Ci(y ofEverett Official Use Only <br /> FEE <br /> 6-0 <br /> • <br /> PEf2MlT# <br /> Owner/Au or zed Agen Signature ate (Revised 10/1212015) <br />