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<br /> ELECTRICAL FEF-\'MIT APPLICATI •N •
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8887 ( (E)everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: ,'1-4.2-37 //./' / eeraL�i7 2L
<br /> BUILDING AREA(if residential,new construction,remo•el,or addition) SF.
<br /> BUILDING TYPE: El SFR-DETACHED ❑SFR-ATTACHED CI DUPLEX Lf MULTI-FAMILY••#OF UNITS: NI COMMERCIAL
<br /> USE OF BUILDING: j© T G EVERETT' '
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<br /> CONTRACT PRICE OF WORK:$ 69/ 0206)
<br /> NUMBER OF DEVICES(if low voltage):'
<br /> FIRE ALARM? ❑YES 14 NO
<br /> ASSOCIATED BUILDING PERMIT#(If applicable):
<br /> DESCRIPTION OF WORK: .r •
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<br /> OWNER NAME: TENANT NAME(If Commercial): /i06
<br /> OWNER MAILING ADDRESS: smear lQ ,IBX 3707
<br /> CITY .5 j TTZE. STATE in/r4 q /22/2207
<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: (-17e.1 -7-441..) ea.-1577eale.-77010
<br /> CONTRACTOR ADDRESS: sTREET et.7q eOX X44' ,Q ©*�/�/�
<br /> CITY !/Il/t//t• G.-/ STAT i! /� t/ ZIP eyg2,0 L
<br /> CONTRACTOR PHONE:426-2/4�-16944 CONTRACTOR EMAIL: / f iei. 1 /linEg6'k'i�w/r. CDr
<br /> CONTRACTOR LIC,#(IiEQUIRFD: a•E t. 40z CITY OF EVERETT I USINESS LIC.#(REQUIRED): a
<br /> PRIMARY CONTACT: 1l OWNER EI CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 206-730.4544.
<br /> D },,NN1 S Ll Rb(Al CONTACT EMAIL: DDN141S.d.1�4w k!CU IT. C:�1
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<br /> AGREEMENT:T hereby certify that I have read and examined this application and knowthe same to be true and correct Ail provisions of laws and ordinances governing this
<br /> type of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to violate orcancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application Is made and I
<br /> comply witbthe State Contractors Law 18.27 RCW and 288:200 WAS
<br /> City of Everett Official Use Only
<br /> FEE
<br /> .5,
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<br /> PERMIT#
<br /> Owner/Au or zed Agen Signature Date (Revised 10/12/2015)
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