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�' IglIECTRICAL PERMIT AFICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT <br /> PROJECT ADDRESS: 5 EV j E R T T C1A L L 'WA Y 6' 4- I <br /> BUILDING AREA(if residential,new construction,remodel,or addition) H .T, SF �3 <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: C 4 is R/9 P,ZA-c-1T ° ) <br /> LECTRiCAL APPL�CA'IQN 1Nll<O�tMA'Ir1QN <br /> CONTRACT PRICE OF WORK: "? <br /> NUMBER OF DEVICES if low voltage): 30 <br /> FIRE ALARM? YES 0 NO <br /> ASSOCIATED BUIL ING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 3 ti P R L.YC /-J J7 j /()S'l ALL 7 7- NO II-RCA-7%0W <br /> `%0W <br /> E= VAS <br /> �G&S D Om 564- fi 1-�lv�6 (17- �j�{� 170 toe c2 ppL7-, <br /> W t`12E- (,e>t /9-7-- 1- LJ AS Peep <br /> At) t"�NtAQT,t11 �Q : , t�ON <br /> OWNER NAME: A/pA- t Aires J4-1i-1 C-(7 I "At III_TENANT NAME(If Commercial): sA,L-7 e <br /> OWNER MAILING ADDRESS: STREET /Al <br /> CITY STATE ZIP <br /> OWNER PHONE: (OWNER EMAIL: <br /> CONTRACTOR NAME: 15d-/-1/ ) ' E S E L/` <br /> CONTRACTOR ADDRESS: STREET f ( L O>G ,2O C (3 Qc#,._e LC 9�69V -2 2& <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: Y25=306?'���{�f CONTRACTOR EMAIL:)Nps( t60,4 ea.-Fi‘g sec() Com <br /> CONTRACTOR LIC.#(REQUIRED): Sec()AR..I'o 2J3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) G� 5'2132 <br /> PRIMARY CONTACT: 0 OWNER ACONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Y25`-3o <br /> A L VAL aW j /Y° CONTACT EMAIL: SAMA' <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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> // 2_5_/C E 1 Co o9 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />