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'IP ELCTRICAL PERMIT APICATION
<br /> viii - CITY OF EVERETT PERMIT SERVICES �. ORIGINAL
<br /> ` i�
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits
<br /> 11„ 6 -tomt� gni . ® ,t_ ® ® ''.:t2.4. 17:"1"
<br /> Mil(ifi iY ,;;;,,',•7,",-:.'-'7;--:1;7=7,'---,7-10 — V,I`-t��, ,,,,,,'d ' k ,,„-.31,471, �1 t,."y 'li ed r 'td�Z",_ '0'.
<br /> PROJECT ADDRESS:
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) VS ickn_l )a SF
<br /> BUILDING TYPE: FR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING:
<br /> [ d„ L _ 5 1N,„_ : 4� :...Ii( � „-,�;�i ioa :�¢„i�'s�a, �ria irn.4a ,,',:,'„.;:!4'02111,r1' ae a M I' jt11 4
<br /> iis `
<br /> CONTRACT PRICE OF WO` $ 6,7 '
<br /> NUMBER OF DEVICES (i;ow voltage):
<br /> FIRE ALARM? 0 ES 0
<br /> ASSOCIATED BUILDING • -e . applicable):/Jnn t )
<br /> DESCRIPTION OF WORK: V\,N (Arid- ' rolaq (,611inl -ani k-)041' 1,r t .''muK
<br /> %%( 'f& 1l Pick 1 -I n ,
<br /> �{� y "`` xWiyi t'�ii,t 4I s'S ;,'. _"�,"-_- "x�.��n�,i �€ +as;. i:i,ai l,f U�f!ii) :_ -�i {�'(�Ni I� r 1 I.(II�I �F�Guk�'T �i' �dr«'i 'r� :
<br /> f "�L,�i -A it E _' i d i� - ® T,'l -t i�c 7 f'r �p� t (p _ 'i
<br /> ��II@' �s :��i�i F CaiF '� -iM'�I .,_.. �.�� 5i E_-� tri,k Iliiiil CSI NM_.`,ii i r _-�. ��t� ��i i i�� 5141:ii���;�� .-'s,��� f- ��i����Is��.
<br /> OWNER NAME: Pow .ri L yi TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET 5 ./?� � �
<br /> Ajdri e
<br /> CITY -efr.e.-+"�� STATE ZIP qr///��
<br /> 7�'
<br /> OWNER PHONE: L'l 7� ail 4 OWNER EMAIL VVV___ V
<br /> CONTRACTOR NAME: 13}(1-6 Pfi
<br /> CONTRACTOR ADDRESS: STREET 1 1 / d ,5-j--, ,u ` I
<br /> CITY W`'`' '' 4°
<br /> Vfl7 1, --/
<br /> STATE t A / ZIP q l
<br /> "ll// l
<br /> -i/I.
<br /> CONTRACTOR PHONE: �Q CONTRACTOR EMAIL: 10-( 0)/0„0 aneC'�'
<br /> CONTRACTOR LIC.#(REQUIRED). it le, OF EVERETT BUSINESS LIC.# QUIRED) g 2 ' 0
<br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify)
<br /> CONT CT NAME: CONTACT PHONE:1- J.- 1 13
<br /> oY I o479(7-myy,. ...( CONTACT EMAIL: IV 1 bi,�P 0,,„LI,, `L ,,,-„0,--)AGREEMENT:T hereby certify that I h' e read aexamined this application and know the same to be true an correct. All provisions of laws and ordinances governing this
<br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That lam 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 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> .1 .....S ./...•••••••--
<br /> PERMIT#
<br /> / FZef/6- E o 3- t o -
<br /> Ow : IA •v't Si. ature Date (Revised 10/12/2015)
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