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CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 I (E) everetteps@everettwa.gov J www.everettwa-gov/permits <br /> PROJECT SITE 9NFOR _nO9 9 <br /> iQ <br /> ' <br /> PROJECT ADDRESS: U . i✓G AD E llcvc A air` L Lit) ET , <br /> � (�{ <br /> I �„I <br /> BUILDING AREA(if residential,new construction,remodel, or addition) S 01666 SF 4 i, col Al( - Ell <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: i'c'e L <br /> • ELECT•ICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 1)6 b DO Q <br /> NUMBER OF DEVICES(if low voltage):• 3 6 9 <br /> FIRE ALARM? 0 YES ` )NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable):tbile,DESCRIPTION OF WORK: CG�71 4�C1 5 1 r-Y+�G f 8 01, ( t-e(t 5 i,.4 I\ ` - S d Gt)& c��Ul e, <br /> • - � - - � .CO.NTACT INFORMATION- <br /> OWNER NAME: 0,e1A f;, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 7 j( VC), CA&1 r1 b 1( � i� � ygn (l <br /> CITY /-;„b e�'>✓ STATE W/Y ZIP "j 01( q <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: )V A1 C 0 laC,. ,. ``..�,. <br /> CONTRACTOR ADDRESS: STREET l‘ 1-Fe of Io `V\(L U r <br /> CITY Fed`,r�O}rl STATE PI ZIP C 30)-6 <br /> Amf <br /> CONTRACTOR PHONE: jaw b CONTRACTOR EMAIL: )y114 @. s a'Ltd 44! <br /> CONTRACTOR LIC.#(REQUIRED): ..C,0. LI 1 AI Ai CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0:55/1 el <br /> PRIMARY CONTACT: l]OWNER V"H+=CONTRACTOR..,�©OTHER(Please Specify) <br /> �- _�r.__.�,._,,....,�.... .a.-.�.w.,....�>.�.�....,....:,.��._ �. ...�._ . ...=w. <br /> CONTACT NAME: CONTACT PHONE: ),06` %(-1 - C)Jr() <br /> e rA CONTACT EMAIL: ti / et-4_0 S e (A 0'1 <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be rue and correct. AI!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 or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That lam authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCIN and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 1 <br /> PERMIT# <br /> 1 i g F tSo( - OS3 <br /> Owner/Aut orized Agent nature Date (Revised 90/92/2095) <br />