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44-77 !LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ORIGINAL <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> " u !+�y - - ti r' {' (a a, ' <br /> �����t,�-i it <br /> _ <br /> PROJECT ADDRESS: Lt4 \JU 6 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) l S1.-Q( SF <br /> BUILDING TYPE: 0 SFR-DETACHED,SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> :111 niatMf 1. cRPW c#IO0 �:. ORMAON1 ° <br /> CONTRACT PRICE OF WORK:$ 0/ !NO , <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 11 <br /> DESCRIPTION OF WORK: Li Y� ( l� �� (^V (/�,GC C2-- <br /> o t OU, <br /> rig 3 i u f ��= ll_ ak�t:M7=€max RM 'za <br /> a _ .j-r5 - omi = <br /> _ <br /> OWNER NAME: 4 TENANT NAME(If Commercial): <br /> w ,�OW ( . LeAe_ • <br /> NER MAILING ADDRESS: STREET frot <br /> CITY J STATE " ZIP 1-e/ `! j <br /> OWNER PHONE: - r OWNER EMAIL: i `. (c. <br /> CONTRACTOR NAME: gi <br /> CONTRACTOR ADDRESS: STREET \ A` ( V2A <br /> CITY /V L r STATE LA)A ZIP 61 04 <br /> CONTRACTOR PHONE: l`' \3 CONTRACTOR "EMAIL: ' t k J// <br /> CONTRACTOR LIC.#(REQUIRED)T,W,E,PPM) ZS-14 / <br /> *Q CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 0 <br /> PRIMARY CONTACT: 0 OWNER %CONTRACTOR 0 OTHER(Please Specify) <br /> CO T�T�NAME: CONTACT PHONE: - / I `. 1 \3 ) <br /> et; I adAa, Vs_, "u' t 12 CONTACT EMAIL: ✓\, A <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 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 lam 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 /> FEE <br /> PERMIT# <br /> 0K.) 2 ) E2n0 <br /> Owner/A horized Agent Sig ature Date (Revised 10/12/2015) <br />