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'PPP ELECTRICAL PERMIT APPLICATION
<br /> .. --1 CITY OF EVERETT PERMIT SERVICES
<br /> 44,11
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P 425-257-8810 1... , = efeitwavovi Iftvw,er z. -,..A rr• o‘i permit s
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<br /> , 40 srl: itgigtatM4f1113N
<br /> PROJECT ADDRESS:
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<br /> BUILDING AREA(if residential,new construction,te octet,or addition) SF
<br /> BUILDING TYPE:XSFR-DETACHED 0.SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS; 0 COMMERCIAL
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<br /> USE OF BUILDING:
<br /> * Eel '1.t4,- ,, -,#441 liti ij . .SO ' ,- ON
<br /> CONTRACT PRICE OF VVORK: $ ...ZS()
<br /> NUMBER OF DEVICES(if low,voltage):
<br /> FIRE ALARM? 0YES WNO
<br /> ASSOCIATED BUILDING PERMIT# If a tioable
<br /> -, J-1ESCRIPTIC)N OFANORIt . ,. ,P11.4 ,. ,, AQ 0 ii :j ..., Mirrir ' * At r4Ind
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<br /> -' . '.,f,i,:,' " '' ''. • 1:2-4 .;!:. '
<br /> a.„. , 40..4. k.... ........-...—.......
<br /> OWNER NAME. i1S0to 21)(9C'lleigris k'e-- TENANT NAME(if Commerce ;
<br /> OWNER MAILING ADDRESS: STREET %1,7)
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<br /> O m( fVeite„t,t7 STATE 434 ap g e.:1 lay
<br /> OWNER PHONE: 25' 32.2' 14 2. 0 OWNER EMAIL:
<br /> tCONTZACTOR NA,..ME: CrY00 9
<br /> CONTRACTOR ADDRESS: STREET I Li 15
<br /> CRY tetie.4--. ,.. STATE Aret" ZIP
<br /> ias_ 4::_z3, ,,,3 c3?3 20
<br /> CONTRACTOR PHONE: .3 0CONTRACTOR EMAIL: cs,,,€)/Qhe oh 9 , 44
<br /> ttel 0;4.7 e0
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<br /> ToNTR;WT0F . ouRED)t• Jt i'ilitagilig . 10ITY OF EVERETT BUSINESS LIC.#(REQUfRED): ruzciii
<br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:
<br /> CONTACT PHONE: ii 5 a5ci o,53
<br /> 1 fo?1(210 I
<br /> . _
<br /> CONTACT EMAIL: 0 . ; , 7,.. , , A? IA.0 osa...rty.4ab
<br /> .4,11. r neN-
<br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true end correct All provisions of laws and ordinances governing this type
<br /> of work wet 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 1 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 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> OP
<br /> I • I 1 ,/s- E 0 1-
<br /> 011, ,t.d Agent Signature Date
<br /> (Revised 9/23/2016)
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