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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 I FAX 425-257-8857 I (E)everetteps@everettwa.gov( www.everettwa.gav/permits <br /> PROJECT.SITE INFORMATION <br /> PROJECT ADDRESS; 13'1 rttit: l• d �, <br /> BUILDING AREA if residential, new a , i,c i1 �Q 'r aid t <br /> SF <br /> BUILDING*TYPE; 0 3FR-_}c i A.,-IED 0 SFR-Al,T"A;; {D 0'Yip' =' 0 MULTI-FAMIL`!-tt Cr-UNITS ❑i.0Milr E <br /> USE OF BUILDING! <br /> ELECTRI CAL'APP LICATION:INF,ORM,AtION <br /> CONTRACT PRICE OF WORK: $ it <br /> NUMBER OF DEVICES if low voltage): % <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if a.rlicable <br /> OESCR1PTTJt) •F WORK ._— <br /> AiOP <br /> 14 al 49 a tis Lit <br /> _ COIhtAdt INFORMAMLON <br /> OWNER NAME: 71♦1 9 (f <br /> ,sia 40,` TENANT NAME If Commo.tr,:ial <br /> OWNER MAILING ADDRESS: aTrte_r <br /> Jnr , 1/y AL 4 argrs A, zir rt i <br /> EEEME �► ..«.M" OWNER EMAIL: <br /> OtTRA;TOR NAME: <br /> CONTRACTOR ADDRESS: t Tr- W° ' <br /> err (0.3-'t i 201 <br /> STATE � <br /> CONTRACTOR PHONE: w *to ( .70 is CONTRACTOR <br /> r1?C � -id <br /> ".. EMAIL „wit <br /> aw <br /> CONTRACTOR LI�-t —E• Ui:C?) r►�1� s tdT — <br /> diff OF EVERETT BUSINI LIC,#(REQUIRE[): ■ <br /> PRIMARY CONTACT: 0 OWNER +"i I, Cs V <br /> CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: 9Q5 'asci Co—Tx <br /> 1 'Oda le <br /> CONTACT EMAIL: ( > :j#I intan •corn <br /> AGREEMENT.!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 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 al 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 /> 0J/10-Le- fr-56Luvu <br /> Owner/Authnrized Agent Signature O < <br /> Cate (Revised 9/23/2016) <br />