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10/18/2017 10:48 #2731 P. 001/001 <br /> ,411./oizz_i- <br /> ELECTRICAL PERMIT APPLICATION <br /> J J <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)everettepsfgeverettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: . O ELI a GV "1*S6 <br /> BUILDING AREA(if residential,new construction,remodel,or addition)_ SF <br /> BUILDING TYPE: 0 SFR-DETACHED I r -TTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: &COMMERCIAL <br /> USE OF BUILDING: CO 4i./H :.� I r <br /> . :..:.: ...::: <br /> . -.. M r)0►k�Arr.I040IA►T o . :Itircislll. TION:'; <br /> CONTRACT PRICE OF WO"ffr _ i V . <br /> NUMBER OF DEVICES(if Io take) -.-, <br /> FIRE ALARM? D YES 0 NO _... <br /> ASSOCIATED BUILDING PER T#(if a.di—ble): <br /> DESCRIPTION OF WORK: • • 1100— 0 unsifc / i 7 iffo u 7 <br /> �.. <br /> .:�ONTAQ'll":INF610YIATIQI��' '.. :�. • <br /> OWNER NAME: 77 i -/ v 7L TENANT NAME(If Commercial: <br /> OWNER MAILING ADDRESS: cancer C /2 �' '61111 ��• �ryr / <br /> STATE (Al* <br /> OWNER PHONE:age6Q,,To OWNER EMAIL: <br /> r <br /> CONTRACTOR NAME: SYMMDe4 cf. 41 A .r,E'f24/GC <br /> CONTRACTOR ADDRESS: STBeer 340) G f'fel fJ Alee110 <br /> cgm <br /> _ STATE Zya i r <br /> CONTRACTOR PHONE: �C Y)J' "7 /R/( l CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.la(REQUIRED1 el/Am/4r/y21-./' CITY OF EVERETT BUSINESS 1.UC.#f(REQ RED:0/434.7 <br /> PRIMARY CONTACT: CI OWNER CI CONTRACTOR O'OTHER(Please Specify) - <br /> CONTACT NAME: CONTACT PHONE: Y INS e2.3 <br /> PA? d / !7 a ft_ CONTACT EMAIL: <br /> AGREEMENT I hereby certify that I have reed and examined this application and know the same to be true and const All provisions of laws and ordinances governing tNs type <br /> of work will be completed whether specified herein or not. The granting of a Derma does not presume to give authority to violate or cancel the previsions of any other state or <br /> local law regulating construction or the performance of aonstructlon, That I am authorized by the owner of this property to peritum the walk for which application is made and! <br /> comply with the Stats Contractors taw 18.27 RCW and 296.200 WAC. <br /> 2) r b/rr#C City of Everett Official Use Only <br /> PERMIT# <br /> /o lea E l3? <br /> / ori ant Signature (Revised 9M/2018) <br />