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<br /> 01 ELECTRICAL PERMIT APPLICATION
<br /> CITY OF:EVERETT PERMIT SERVICE.
<br /> 3200 CEDAR$TREET, EV RETT.,WA 98201
<br /> (P)425-257"-8810 1. FAX 425-257"-885? 1(E)r v retteps everettwa.gov} wr iw.everettwa.govtperrmits
<br /> iQ r , t a i° -.. 1, `p 01 SsTI INFO RM i►'".I 00. #1 ' : ,,. . R
<br /> PROJECT AODRESs ... ria r^. o - `' ciok ' ' \ -QOZ. e mug-i 1 0 $\Vd
<br /> BUILDING AREA(if residential,new Instruction,remodel,or addition)" SF
<br /> BUILDING TYPE: 0 SFR-DETACHED :0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-.:#OF UNITS: 0MMERCIAI
<br /> USE OF BUILDING: k ‘‘ . ,, 'h` .,`l'`-°
<br /> a...a. ,. ELECTRICAL.APPLICATION1NFOI MATIOra '
<br /> CONTRACT PRICE OF WORK:$ r.,,7 r °Y001
<br /> NUMBER OF DEVICES(if low Voltage): 7
<br /> FIRE ALARM? ©YES )41.0
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): 4)4
<br /> ;DESCRIPTION OF WORK: acAt ik, eink. t.1..0. Vr ,,li i +" _ , ,r i t^ 11(14, ,e)„el
<br /> , ': �► �
<br /> ,: Clt+l !!CT's�I�tiltlllllkTl#,11� .�.��. _ ��`
<br /> OWNER NAME: , s & Vete7171,_
<br /> . TENANT NAME(If Commercial): ,�"" f .P; ' ?Ca. e., c t%1 m Ciiitfr
<br /> OWNER MAILING ADORES STREET
<br /> CITY wt/ yeSTATE zap?02.4/
<br /> OWNER PHONE: % J OWNER EMAIL: }ii
<br /> CONTRACTOR NAME:_ OF il3 t-8 c,t,is, E/fescilt . �,-
<br /> CONTRACTOR ADDRESS: STREET e 902 '4,, I LL
<br /> CI t 015 t'".. CITY STATE tx I z., j{
<br /> CONTRACTOR PHONE: b ; 7-->6r C.. CONTRACTOR;EMAII.: b Oct f .1 � y C` , .a , Co 1.
<br /> . CONTRACTOR LIC. REQUIRED): r,/ ' e,/ I t CITY:OF EVERETT BUSINESS LIC..''REQUIRED:
<br /> PRIMARY CONTACT: DOWNER i ( ONTRACTOR 0 OTHER Specify) r
<br /> CON .CT NAME: CONTACT PHONE: Ao C,„ ' .// _ Al t,�°
<br /> 7
<br /> r se , CONTACT EMAIL:::
<br /> A0h5 ME t7 i natally cattily thea t.1he aci andararrnined this pOl/car and ithoWthe me 4e trtle ancicorrect Aill provAons ortaws,11'..,c lln:cas;opya,caing thls,type'
<br /> of work wtk Ire cprnpieted whether specified herein a not. The.granting of a.pemrtt*oes notwresume to.giv ,Sytitarit+to wo(ate or caneel the pr kion,'of any other stale or
<br /> tecilliiiiregutatlr*'rehab-action or the perfa inance'cif coh'structton,,That I era authorized by the ownerofthts property to perform the work tor whfch.appttcatlon is made and I
<br /> compty with the State Contractors Law 1tf. 1 PCiti anct g.,. WAC.
<br /> CO of Everett Official Use Only
<br /> PERMIT#'
<br /> 21 //,
<br /> E I " I b(o
<br /> Owner/Authorized Agent Signature Date . (Revised V23)2ta16
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