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•ECTRICAL PERMIT APILICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ( (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: 10 Sg" EUerr,b}- itAfalt (A)a.4.3 <br /> fit"(-t <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> CONTRACT PRICE OF WORK:$ 00 . ,) o <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: etAt%A ,GA- +ao (j ' (jftlx.lAKt' (Lfhu� Vi'f14. 40 <br /> eXici, rain-{— <br /> t 1a�"�'&::4�kw {exispr��4 ^. ie'� '�.,.c i.e v 3 $ t c 3" P ,+-�' .:ua �+..:.t r te`v fi i-" Y,_ F..�'h ±'y. ter f > }' ys .,.., <br /> t*m'.k� '?�, �Y3, ��.3r �.u'.ri �-�'v x�s. � ��.�'S S� '�. rw( :;c'��f" :S.-..�k a� d1.a4Kl.:s� '�'Lw����.��.r?`� .:�..� �ky�re�,e��,^.,fy. �:i t`�.z.4 Y .l,arc ,�.,f ,.4 1 s ����v¢� <br /> r ,ou, a v, t t a e ✓� .��..k `Yz u..'..,n:'S 4n>,<:oe..o g i _siea mtvi wgAv' �' lgig g �� J zeg oR f <br /> CONTACT`INFORMATION <br /> OWNER NAME: S tA (ZCo (1/44a tote ,,�,}- "i"� TENANT NAME(If Commercial): (,yyt o(r1w,, P . <br /> OWNER MAILING ADDRESS: STREET 2.9 10 S(per A.0 t) S �Oa J <br /> CITY ge,((t.V0.4„..- STATE tits ZIP argot) <br /> OWNER PHONE: 41,2b- LI SS- V46O OWNER EMAIL: p f-,roc }p(d,��k rCAO, c.o <br /> CONTRACTOR NAME: A.V(Ak-A/ glea-WL ADDRESS: STREET I1-0 dz.4 14A0,4‘,,e,(' to—AAAp <br /> CITY K,1n„W(9V STATE UJ ZIP �D d <br /> CONTRACTOR PHONE: 2* PS3 —(o t'33 CONTRACTOR EMAIL: fAVA.e.kcc-Q. ino4-IMGM6rin <br /> CONTRACTOR LIC.#(REQUIRED): QrV pirT(k.e- 104( t LA CITY OF EVERETT BUSINESS LIC #(REQUI D). ti(Ge <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) Sicd w C.o iti ll i4 o r <br /> CONTACT NAME: CONTACT PHONE: 7_0(o- (j se-e147- <br /> t C #. 40o-intCONTACT EMAIL: .t- T{ Y1 GO v.(��wv 11 co KA- <br /> AGREEMENT:I hereby certify that t 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 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 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 /> g/7/fe E t gOg-o 3( <br /> Owner/Authorized Agent Signature Date (Revised 923/2016) <br />