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<br /> tLECTRIcAL PERMIT A LICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-267-8810 I FAX 425-257.88557 I (E)everetteps@everettwa.gov 1 www.everettwa.govfpermits
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<br /> PROJECT ADDRESS. -
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) , SF
<br /> BUILDING TYPE: I FR-DETACHED 0 SFR ATTACHED 0 DUPLEX El MULTI-FAMILY #OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK$ 01071
<br /> NUMBER OF DEVICES(if low volta90) . ,
<br /> FIRE ALARM? 0 YES 0 NO,
<br /> ASSOCIATED BUILDING PERMIT#Qf applicable):,
<br /> DESCRIPTION OF WORK: r - - . .. + ,L., f + L - ,
<br /> (OWNER NAME: ' ; TENANT NAME pf Camtnerciai)
<br /> OWNER MAILING ADDRESS: STREET 144,6m
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<br /> env - / iir STATE i i ZIP 6¢ (k-D"0/
<br /> OWNER PHONE ~- ,.(Lob 5-- -OWNER EMAIL
<br /> CONTRACTOR NAME: ,r f.
<br /> 4„p CONTRACTOR ADDRESS: s-rREET —1/
<br /> CRY Th It 1 i � sTATE ZtP f8-.4.1(..".,/,‘1,01—
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<br /> CONTRACTOR PHONE: P _CONTRACTOR EMAIL: noY44 >
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<br /> #{ D) RETI BUSINESS LIC. EQUIRED)
<br /> 'CONTRACTOR LIC b�Et1UIRis � Cl7Y OF lv1AE S
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<br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR C OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:
<br /> , .Y. 1. COMTAOT EMAIL;
<br /> AGREEMENT therebycertify that I have read and examined this application'and know the same to be true and coned. Att pmviisions-oflaws and ordinances governing this type
<br /> of work Witte completed whether specified herein or not,. The.granting of a permit does not presume to give authority to*date or canes the provisionso any ather stale or
<br /> local law regulating oonstn{otion or the:performance ofconstructlbn That/ern authorized by the owner of this plop**to pod"orm the work for which application is made and I
<br /> comply with the State Contractors Law 18.27 RCW and 296.280 WAC.
<br /> City of Everett Official Use Oniy
<br /> PERMIT#
<br /> . ,../ /2 — /-7 E e - c2 - 1 Co
<br /> Owner/Authorized Agent Signature :l Date (Revised 9123.x2016)
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