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01.411 ELECTRICAL PERMIT APPLICATION
<br /> .s . CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,:EVERETT WA 98201 I
<br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everettepseeverettvvagov 1 www everettwa.gov!permits I
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<br /> PROJECT ADDRESS: 3t00-7 e .t ...-
<br /> BUILDING AREA(iresideneal,new construction,remodel,. ) l-1 1 SF
<br /> BUILDING TYPE: El SFR-DET s...o-'" TT ED 0 DuPLEx El MULTI-FAMILY-#05 UNITS: El COMMERCIAL
<br /> USE OF BUILDING:
<br /> r`n < ,c AST- ni 4 4 �. #y ,:a 1:1,7r7,:7:-rt 01 4 i `u q,'
<br /> �, <. � _..>�._•,��-tee �, F,. as,�"�ia.3''� ' - -
<br /> CONTRACT PRICE OF WORK:$ ‘ `Al Ob
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<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? Ci YES El NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: t''"r�- "t"# V - ., -Ii- `- •' c, u 00,,,,,„e„.21, -sem f eva.cf-e-
<br /> •
<br /> ,, ', �, , ,,.',. .,. ,M �i"., �• c #� „,,,,,., .,..,,', ;,_ ,, <a.,_,,t,: .fix?....OWNER NAME:tti,\k. w.Ma.r ... 61 r,,,. . TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sinner ISL.C7 .:1 Ir-0 c-C.•c.. kr . C;Li e'
<br /> crit 9 ti:...kith. STATE { ZPC1c L? .'
<br /> OWNER PHONE at —'SCIS `1 t, ERE € 10- ,f-
<br /> i t OWNER EMAIL: v-941 ,r1,,,, �' . ..;'`1r}'�.t ,. .
<br /> CONTRACTOR NAME: t.c 4- t\o.t` -4L:'1• 1lar`,.,. ,. (LArs
<br /> CONTRACTOR ADDRESS: STREET --A,C,t-2.,0 %a - , �t
<br /> city A1C).Ne,.k5 ,,Vke sTATE t - aPCk `7 O
<br /> CONTRACTOR PHONE; 4-3... .,,S Lt( 9 CONTRACTOR EMAIL: f' `C is I NO t.k...c4rc "+h t 4, A .tom„..
<br /> CONTRACTOR LIC #(REQUIRED) Qv S ct. s M,S 1,13 CITY OF EVERETT BUSINESS LIC #(REQUIRED)Q 4"'t4 V<
<br /> PRIMARY CONTACT: 0 OWNER ONTRACTOR 0 OTHER(Please Specify)
<br /> CONACT NAME: CONTACT PHONE: Lk.D. -3 ''''S- O,a.9
<br /> Ocksk e rte°- Q..., ye Ili k CONTACT EMAIL: 6'Y. -►:L£' t� YY weal.,,1 Lam...
<br /> AGREEMENT:I hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type
<br /> of work will be completed whatherspecified herein or not. The granting of a permit does not presume to give;authorityloviolate or cancel the provisions ofany Other state or
<br /> local law regulating construction or the performance of construction. That l em authorized by the owner of this property to pertprrn the work for which application ismade and!
<br /> comply with the State Contractors Law 18,27 RCW and 296.200 WAC.
<br /> City of Everett Oficial Use Only
<br /> 0
<br /> r 0-ts--
<br /> PERMIT
<br /> 6jE i $( D - foo,
<br /> Owner/Authorized Agent Signature Date. (Revised 9/23/2018)
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