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/ ILECTRICAL PERMIT AICAT1 N <br /> I�►iNiiiwCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROTECT SITE INFORMATION; <br /> PROJECT ADDRESS:3ZE/ COLeY AVE, FVEkerr GO f} q8.20, I <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ( COMMERCIAL <br /> USE OF BUILDING: CHURCH <br /> - t PPLIICATION INFORMATION <br /> CONTRACT PRICE OF W e ' :$ <br /> ..-4"Co <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES IA10 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: rho-red et e0k-ci"A. S -.14c-I'J •--o,r 1,, y,,fS -f,�,,,.� c.)8- y\\- +...=' 11eW <br /> VJw.t� t,Sal\J ',vim 194_ roor, 0,84. SoCic.� 1-Eal� / I-1All wo.y,J <br /> :,,sem\\ek vev..k�\a4:o. _,_,.1 ;w )e34\-1-,-('o0 pq- �l <br /> '.?aA''.-- , , a re_cess-rc- IsS‘-.N-s ,AA-0 el<v4�.,c- 51._4-# -Cv\o\- �2ov.e ,D� y �.. <br /> 1-- ,,-'..,iIA ► . ,e <br /> r.4 Q<G4%0.. da\It&- <br /> CONTACT (INFORMATION - <br /> OWNER NAME:UN/TY CM f R Po5/7 vE- VIN 6 TENANT NAME(If Commercial): 14 1n <br /> OWNER MAILING ADDRESS: STREET 323/ t _0 _.S Y A VC <br /> crry EVERE-7T STATE Wef ZIP Ci820I <br /> OWNER PHONE: /Z5-25-S- ZZ t/7 OWNER EMAIL: EVER ETT(JN ny 6 FR 7/E2, (o'I/1 <br /> CONTRACTOR NAME: OU )rte <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: t( ,0 g O' --°PL it k <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <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 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 I am 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 RC W and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 9 ,q,S <br /> PERMIT# <br /> E \ ( <br /> o -1 `` (.0 <br /> i tSps i, tinL4.,J/74°'t();-() Z/ 3/7 <br /> Ownerthorized AgeniSignature Date (Revised 10/12/2015) <br />