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SP ELECTRICAL PERMIT AUCATI N <br /> Niiiwi <br /> CITY 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 /> PROJECT SITE INFORMATION' <br /> PROJECT ADDRESS: 6®'U. C, e--..i. <br /> ..P&L E- <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF ' <br /> BUILDING TYPE:5eSFR-DETACHED 0 SFR-ATI-ACHED <br /> �/0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> f <br /> USE OF BUILDING: `2 l/1 L! ,�� -p / 1--Y. <br /> 7 71e <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 1g-01 <br /> 15- <br /> DESCRIPTION OF WORK: <br /> ktfeir GiX-c141 r GIA.,-, C hU- pan&/ boated . <br /> 0-1-rcf -igfeei--- e %e c- r c ea --e )7') 1 04421 ,, . <br /> CONTACT INFORMATION- . <br /> j <br /> OWNER NAME: 01_14613E74 61'f ` ii'NM 14 TENANT NAME(If Commercial):�Q , <br /> OWNER MAILING ADDRESS: STREET (2 J2 Gk& cl L- the <br /> ¢i 77 crr' //'' //G'' I/ `- STATE °2PZI1 <br /> OWNER PHONE: 2.0 -3 7.-/T2(O 2 , OWNER EMAIL: 5 o -/>-r,e, 7 sop,Et)p,,,,..d..co-)-o <br /> CONTRACTOR NAME: .S E-,L F-- <br /> CONTRACTOR <br /> -CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> —+ <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!have read and examined this application and know the same to be true and correct All provisions oflaws 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!am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> IP . <br /> PERMIT# /4 77Qk 7 <br /> 6 2-®7 8r E t 80f-1,CS <br /> Owner/Authorized Age t Signature Date (Revised 10/12/2015) <br /> ,pi) TZ OPS eF-cde,--- <br />