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tLECTR C AL PERMIT Adi LUCCA11O
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 ( FAX 425-257-8857 1 (E) everetteps@everettwa.gov wvwv.everettwa.gov/permits
<br /> EJECT SATE IINF I PILK-7 U ::::.... .
<br /> PROJECT ADDRESS: 9 i r 12ce*f u3e4 1 pc( 6? -f''
<br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF Zt�
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL
<br /> USE OF BUILDING: ae,o i , - i • A 40'
<br /> ELECT IICAL PPLICATllO ! INFORMATION
<br /> CONTRACT PRICE OF WORK:$ OD
<br /> NUMBER OF DEVICES(if low voltage): _
<br /> FIRE ALARM? D YES NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):0
<br /> DESCRIPTION OF WORK: pdd j1) ' ' Pii4� A asp i-,i e-f" /
<br /> tA)ooa y1+op area. . f-.ect X` l pail 04 rzo Zoe 3 4co ..
<br /> et-06Leix4 vtleked13 i
<br /> ,:. .C..._ :.ACT INFORMATION -.
<br /> OWNER NAME: 11'1,UILt( Teo S'f t Cr TENANT NAME(If Commercial): Soo TSI e Cw..eder
<br /> OWNER MAILING ADDRESS: STREET 7/94c / 5�gC
<br /> errs Cued' STATE U c ZIP dig(2,04/
<br /> OWNER PHONE: ,OWNER EMAIL:
<br /> CONTRACTOR NAME: 0 v111e- -6(eA 'Ai1/4.
<br /> CONTRACTOR ADDRESS: STREET e 9-.}:2•4, 1.2 '"7
<br /> CITY OA,C. ASit ' _ &G14 STATE ut„)CL ZIP 9k?:73
<br /> CONTRACTOR PHONE:ip,00660°1,0 r"4 L.oct CONTRACTOR EMAIL: b(`dL{ p✓t h2.0 e C
<br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5-4'780
<br /> '
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<br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:: // CONTACT PHONE: "3 (orb 'g��r- E71'©
<br /> 16(6 l 6r)n �i CONTACT EMAIL: 1010 \oorineiree... Qom
<br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
<br /> type of work wine 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 1 am authorized by the owner of this property to perform the work for which application is made and!
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> \c't2 - Sa
<br /> PERMIT#
<br /> 44 1,S02 —2c1
<br /> Owner/Authorized A.- Ignature to (Revised 10/12/2015)
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