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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 I (E)everetteps@everettwa.govI www.everettvva.govipermits <br /> 0444**T4,11*114,6' At10!4, <br /> PROJECT ADDRESS. Afije• <br /> BUILDING AREA f residential,new construction,remodel,or addition) SP <br /> BUILDING TYPE , SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY #OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> 104000ortkinitiolt ' iitt*Ott <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICESilf lowvottale): <br /> ASSOCIATED BUILDING PERMIT#lifttpettoable): <br /> flR1?XIOOF :. <br /> .400 JittgOttiftAittjafi <br /> OWNER NAME: Act 1 n TENANT NAME tif Comtnetefel)-;, <br /> OWNER MAILING ADDRESS; STREET <br /> 1,i0jorki n tt. <br /> STATE ZIP 4 20 <br /> OWNER PHONE: 5 3 <br /> c?.5qOWNER EMAIL: <br /> CONTRACTOR NAME Auk e <br /> CONTRACTOR ADDRESS: STREET <br /> )4 15 Taro ad <br /> cn STATE t4igoe3r ZIP 20 I <br /> CONTRACTOR PHONE. <br /> jONTRACTOR EMAIL: <br /> —COtfrgAtrrt:Alie,#(FkEtIVIRE014 Ag wdb CITY OF EVERETT BUSINEsS LIC <br /> PRIMARY CONTACT CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE Lj5 5q <br /> 1 date CONTACT EMAIL • 0, tan .62:411 <br /> AGREEMENT:thereby certify(hail have reed 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 tam 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 /> 1! <br /> E OO <br /> . ().4 <br /> OwnertAtIthottzed Agent Signet-4re Date (Revised 9/23/2016) <br />