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ELECTRICAL PERMIT APPLICATION <br /> w- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (T')425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.govtpermits <br /> ' Oa II T SIiTE <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residantlal,new ons ru..tIorr, remodel,or addition) SF <br /> BUILDING' .TYPE. , — -DET _ � A .. .. . <br /> ACHED 0 SFR-ATTR CHER 0 DJ;LX 0 MULTI-FAMILY-t#Or UNITS• 0 COMM- <br /> ...'.\41A:...... <br /> USE OF BUILDING: <br /> mss' <br /> h Viz& „' P ''117184`„‘ <br /> CONTRACT PRICE OF WORK: $ 0 o° <br /> NUMBER OF DEVICES if low voltaee.; <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT,# df ao Iioable) <br /> f a * *( <br /> :a .,..arm 11' • > , g SI -• r <br /> y,..'4.,7--1.14;,4,-)Z- sy R, .::7I','-',.---:,,,, may. <br /> OWNER NAME: tdiPinktit. <br /> �,; TENANT NAME If Commercia <br /> OWNER MAILING ADDRESS; artaar - ;; <br /> OWNER PHONE: +7 <br /> �' i9bVLER EMAIL: <br /> et <br /> CITRA:.TOR NAME: 9.4 y <br /> O£NTRACTOR ADDRESS; <br /> )i(5. o <br /> ",- ., 1/4—') fTATE; A � .. <br /> 4- <br /> CONTRACTOR_PHONE: <br /> e.„ + .' CONTRACTOR EMAIL: tit 'Ai ,� <br /> ' .�F*';+�C'�`L$ 'I.�Itrr`<a�}� CtCJXR ); ' , :eit`ditT'"' r s � A... �...�t "8 or_if. r s1 Y14o is C OF EVERETT BUSINESS LIC.*REQUIRED t i r <br /> PRIMARY CONTACT: 0 OWNER r�ry .M� <br /> CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: <br /> eAtliaJe CONTACT EMAIL r,, <br /> AGREEMENT:l hereby certify that have read and examined this application end know the same to be true end correct. All provision laws andor'inences governing this type <br /> 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 or construction. That I am 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 /> PERMIT# <br /> t •1 E L o — 10,5 <br /> OwnerJAutiuftgd Agin(Stgaa#daae <br /> Cate <br /> r(Revised 9/23/2016) <br />