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0 #2666 P. 002/002 <br /> 9/27/2017 09:0 <br /> PLECTRICAL 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 J(E)everetteps@everettwa.gov( www.everettws.gov/permits <br /> PROJECT ADDRESS: C r. : �( G 4 A <br /> BUILDING AREA(if residential,new construction,remodel;or addition) SF <br /> BUILDING TYP5 R-DETACHED .SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS:^ D COMMERCIAL <br /> USE OF BWLWLNt3: S' ^ <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICESif low voltage): ~ <br /> FIRE ALARM? 0 YES 0 NO -'— <br /> ASSOCIATED BUILDING PERMIT# if a Iicable: <br /> DESCRIPTION OF WORK: <br /> CQMTAT <br /> OWNER NAME: �, O &A•/qe /1./144 f el, TENANT NAME(If Commercian:::: <br /> OWNER MAILING ADDRESS: mar ,- I / 4 A <br /> G /N / / I STA1E ZIP 411. , 'If2Vy <br /> OWNER PHONE: f OWNER EMAIL: <br /> CONTRACTOR NAME: 4 . /! f . -/�' J� <br /> .CONTRACTOiR ADDRESS: sin Tot I Erle.C1 <br /> cm! C ' ..., �.� STATE <br /> CONTRACTOR PHONE:(Of 2/1? 2/b / ICONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#REQUIRED): 3'/ Z / <br /> JI CITY OF EVERETT BUSINESS LIC.#1FtEQU[RED CVO -74� <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE: Y. / 22 <br /> C 4 RN ELI Le D 77 -k CONTACT EMAIL "- <br /> AGREEMENT:I hereby certify that I have read and ascamined this application and know the name to be true and correct AS "7 +• <br /> of work will be completed whether specified herein Or not. Thelate nr cancelb laws and conn of any <br /> other <br /> state this type <br /> kraal law regulating granting of a permit does not presume to give authority to vkuate or the provisions bfany other or <br /> �? 9 construction or the performance of construction. That!am authorised by the owner of this pn:wetly to perform the work for which application is made and I <br /> comply with the State Contactors Law 18.27 RCW and 298.200 WAC. <br /> Civ 0f Everett Officfel Use Only <br /> PERMIT# <br /> Owner! fired Agent Slgneture (Revised 9/23/21)16) — <br />