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• ECTRICAL PERMIT AFILICATION <br /> I�►� , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: 347©d ggDy irr (�/4, 19.20( <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFRDETACHED 0 SFRATTACHED 0 DUPLEX 0 MULTI FAMILY #OF UNITS: COMMERCIAL <br /> USE OF BUILDING: t j ))?-c 9t- c 7— <br /> CONTRACT PRICE OF WORK: $ J*OD, ✓\! <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES I.NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: .•w Sfau CZ) '2-7 7c 7s•r��vc1's <br /> 69 b4 geerf6P s-&wr. <br /> OWNER NAME: p-v,k /f cc Io..t. PSfi c 7— TENANT NAME(If Commercial): w,a <br /> OWNER MAILING ADDRESS: STREET 3100 <br /> CITY TT STATE ZIP <br /> OWNER PHONE: LP-ZS—3eS- k'' OWNER EMAIL: <br /> CONTRACTOR NAME: Uta,164 y (icT'r��- - <br /> CONTRACTOR ADDRESS: STREET (I 00 <br /> CITY tV,Ft®4 STATE /iv6a ZIP q�'gZe? <br /> $y7 — ?Y► <br /> CONTRACTOR PHONE: C(�-f— _ CONTRACTOR EMAIL: j�j,cEk t,, l® it'i£ C Tv{r c c rM <br /> CONTRACTOR LIC.#(REQUIRED): V4 AJA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER f GONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:�, ` �C (( <br /> /(lN CONTACT PHONE: Z�- 3a7- 7j� 9' <br /> �� <br /> /I�VYiWCi 'Criv��c:`L CONTACT EMAIL: C _ V fee e- K.T Cove, <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 t 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 ROW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE ���'j)) <br /> V� <br /> PERMIT# <br /> //% E flt®--�1 <br /> Owner/• orized Agent Signature D to��Y (Revised 10/12/2015) <br />