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LLECTR1CAL P IT° APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE I f, WA 98201 <br /> . NIIIIIIIAV,_ , -' - <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> : PROJECT;. ITE;INFORMATION::: : ; <br /> PROJECT ADDRESS: 0 <br /> (a <br /> leo <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: FR DETACHED 0 SFR ATTACHED 0 DUPLEX D MULTI FAMILY #OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: ri(% '\ 0�l1 <br /> :„.:;: ELECTRICAL.APPLICATION INFORMATION : _; <br /> CONTRACT PRICE OF WORK:set t 1:)‘ 6 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERM T#(if applicable): <br /> DESCRIPTION OF WORK: 0 4, At` _ <br /> :: . CONTACT INFORMATION <br /> OWNER NAME: p VZSSQI TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEr1:21AdCtcrptil C::.T. <br /> 4 3 r Y A STATE 1.1 a ZIP ' Lr`� <br /> OWNER PHONE: , I ' —M pD OWNER EMAIL: 16106 S 0 4"- G ; r) ^ .,t,O 1 <br /> //,, 11 <br /> CONTRACTOR NAME: A-1,Nec- W r kam �Au <br /> CONTRACTOR ADDRESS: STREET SE AikA l <br /> ,� <br /> CITY 7-11 STATE ZIP / <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: I • '16 --i <br /> CONTRACTOR LIC.#(REQUIRED): I '' (tattle CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 31L.( <br /> PRIMARY CONTACT: D OWNER ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: / rc ice` ' CONTACT PHONE: 300-1 <br /> tt /f6 l ,v V I v�/ Ij�1 CONTACT EMAIL:j i f , ? AA f ivt Uw 1 <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 tam authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> log. <br /> lk PERMIT# <br /> di /) E\3b1- e "" <br />