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Jan 12 18 09:42a Bob Jack illtp6746777 p,1 <br /> ELECTRICAL PE*:EMIT APPUCATIOJM <br /> CITY OF EVER i 1 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVER>r I t, WA 98201 <br /> (P)425-257-8810 J FAX 425-257.-8857 I (E)everetteps@everettwa.gov I vwvw.everettwa,govlpermits <br /> lPitiDtd1rs9VkgkfFORMii11'IitiB!@ 7-:...:t.-. • • -, <br /> PROJECT ADDRESS: °-7(,o II '. ::1c('13 vi qky 7544yT <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF I Qtg..� ' <br /> BUILDING TYPE: El SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX El MULTI-FAMILY-if OF UNITS: COMMERCIAL <br /> USE OF BUILDING: • • <br /> • <br /> . 0 <br /> .•. • Grp <br /> �iL'.EeG� A�It;L�( ADHk9IL4lFO►tMe0.'R'9OA1 <br /> "CONTRACT PRICE OF WORK:$ /50+D <br /> NUMBER OF DEVICES(if low voitag: :, 1 <br /> FIRE ALARM? D YES Eitrlo <br /> ASSOCIATED BUILDING PERMIT if applica• : . <br /> DESCRIPTION OF WORK: t tit l I-l-r `4•R -r.„.14 .c--r I► <br /> • <br /> OWNER NAME: ,.e._�r 166,,-i TENANT NAME(If Commercial): S;k:,, .,r -,.,A,q <br /> l <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATS ZJP <br /> OWNER PHONE: !OWNER EMAIL: <br /> CONTRACTOR NAME: k�,6ttj 4 j`'-,L. , ? 17\,_,•�+t'e <br /> ICO T CTORADDRESS:r` MEET 14 L\, i ' N At11('e-,e k <br /> "ii=-1-1,,A v CITY CA-.. srAm 1, , • 2.11:. 9-7:)- I <br /> CONTRACTOR PHONE: 6 (0f ,35-1 GP CONTRACTOR EMAIL: t JA Lk. /14i &< ,GQ M^ <br /> CONTRACTOR'LIC.!ArtEQUIRE_9L. t I. S CITY OF E11ERETT BUSINESS LIC.NREQUIRED):b.�6q3-1 <br /> PRIMARY CONTACT: D OWNERC0NTRACTOR I]OTHER(Please Specify) <br /> -CONTACT NAME: CONTACT PHONE: , aCt_- (de 1 - g S. '1...Ce <br /> • • /,L- CONTACT EM ; Y�, 1® �I1 Sl;� �GC'_ ,SIG► ✓Y\ <br /> AGREEMENT:T hereby certify that I have read and examined this application and knowth a e to be tare end correct All provisions of laws and ordinances governing this <br /> type of work writ be completed whet ersp armed herrn ornot The granting of a permit does not presume to give authority to violate or cancel the provi:rons of any othersfate or <br /> loco.llaw regulating construction orihe performance ofcontra#ion. That Ion 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 10.27 RCW and 25E 2a0 WAC <br /> City of Everett Official Use Only <br /> 'FEE <br /> 50 t------- <br /> I <br /> -----~I PERMIT* <br /> .....4 I —-7...... ...- 1 y E (20( -0_9_E_ <br /> OwnorlAnIhor . • Signet 4 <br /> Date <br /> (Revised 10112J7015) <br />