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ELECTRICAL PERMIT AILICATICN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.govlpermits <br /> PROJECT SiTE INFORMATION <br /> PROJECT ADDRESS: f0 /O7 Airport- g. &'utnaht / tJo` G reit/I <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: i :COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ S00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0-NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): rr__� ) <br /> DESCRIPTION OF WORK: 5/e AYi�LCG�. 7 0 ofS,'w'k . co/Je- but-Hess le.. (AN, f- <br /> CONTACT INFORMATION <br /> OWNER NAM s-,;da}r,te jZ.Cooce/ 5e. )key . TENANT NAME(If Commerci <br /> OWNER MAILING ADDRESS: STREET //Q s/OZ ,91:r port �b <br /> CITY eVerat- STATE WA ZIP FB^ZOL f <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ?jkkL- S Ki Ek&eicav( Cip;,ri're:di)N d.ror.A. 1)GiqS (•1 u-c_ <br /> CONTRACTOR ADDRESS: STREET 220 Q (, Cefe� ,Jl UU <br /> CITY L4.Ia4' SreAki0.5 STATE (JG ZIP gr'LSr <br /> CONTRACTOR PHONE: 360'. -env/ CONTRACTOR EMAIL: ft b bts kelrc_-r;c r1aJ6 fwe,,,i, cow, <br /> CONTRACTOR LIC.#(REQUIRED): ZLjec Er L 7 32Ck CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 6 56 6.03 <br /> PRIMARY CONTACT: 0 OWNER IA.CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 3 co -16/ Op/i <br /> /.20Te SC LIN CONTACT EMAIL: aa.te.• 61U..cky Gc,frec,/J1W F v ✓/ CO4+it <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 i <br /> type 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 1 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 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> . SO <br /> /" // <br /> ,..--X/ PERMIT# <br /> Y-30 -7 E ISOq ` 29I <br /> Owner/Authorized Agent Signature Date (Revised 90/92/2095) <br />