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Zo S4455 e. est. <br /> ELECTRICAL PERMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET. EVERETT, WA 98201 <br /> (P)425-257.-8810 I FAX 425-257-6857 I (E) everettepsgeverettwa.gov www.everettwagov/permIts <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: No4 se ki ER 6 rr * NOM <br /> 4"1"dr&X#17; WP <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED D DUPLEX 0 MULT1-FAMILY-#OF UNITS: gr-CLOMMERCIAL <br /> USE OF BUILDING: ireit,„,z, <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ iet, 41" <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES %NO <br /> ASSOCIATED BUILDING PERMIT#((f applicable): <br /> DESCRIPTION OF WORK: S)pr,1" (4) /AV (.?4;"C-0) S' A4e ,0444) St://t.0 Adnotif aeld4 <br /> t4-04,00; <br /> CONTACT INFORMATION <br /> OWNER NAME: 16(11 /11,191014114 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 44tn tk) 4+ettpla <br /> cry ),90t.12,14, STATE OM 2,P Clq ZO 2. <br /> OWNER PHONE:cf:PCI) ,—5950 OWNER EMAIL: iviatimha iti tte-4y(..Ath <br /> CONTRACTOR NAME: stekta figt-h,:r. Of 39t2CL 11P„ ri&- <br /> CONTRACTOR ADDRESS: sIREEI M 4-ettitnek <br /> qq2o2, <br /> CONTRACTOR PHONE:(.604)63r.),- q 30 CONTRACTOR EMAIL: b42 tYte44-1--tteele, k tete+ <br /> V <br /> CONTRACTOR[IC.#;REQUIRF.D). rettit24-e 11%9 jjkA CFTY OF EVERETT BUSINESS LIC.#(REQUiHEDy_ey <br /> PRIMARY CONTACT: DOWNER CONTRACTOR 0 OTHER(Please Specify) —Al.& I --- <br /> CONTACT NAME: CONTACT PHONE: • - 35- 3 30 <br /> ? 6–bact4CV CONTACT EMAIL: vote, rAgAA4,":414?„ - • <br /> AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and orclinances governing this L. a <br /> df <br /> work will he completed whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel tee provisions of any other state or <br /> local ierr regulahrig construction or the performance of constriction That I am authorized by the owner of Um property to perform the work for which epplzation is made and I <br /> comply with the State Contractors Law 18.27 RCW and 2f45,200 WAC <br /> Thats;ft. <br /> Cu irt) r-or- cie ?4,r4-vi"- <br /> szpv-isag-1130 <br /> city of Everett Offictat Use Only <br /> PERMIT# <br /> Y4-4.6" E ‘SOL -622 <br /> OwnerlAuthorized Agent Signature Date (Revised 9/212016) <br />