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ELECTRICAL PERMIT APPLICATION <br /> ,iirwi, CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8887 1(E)everetteps@everettwa.gov j vwrw.everettwa.gavfpermits <br /> PROJECT ADDRESS: 4<41,4:\ \jve).4.,..) Dr, --:).z... <br /> BUILDING AREA(if residential,new constructia r-e7nc r addition) .24-kill SF <br /> BUILDING TYPE: 0 SFR-DETACHED Q(R-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING:Yl.rtiSi2 <br /> f <br /> -ry E ; rl�;; 5 f.$ �d E06*-0104 1 4P44 *tiON 3 yf <br /> ,.,..`-... .... ': t; . .�,,,.. ....{: .. ;,. .. .. \ " ��� .' �.. .. :.....`C�... � �, <br /> CONTRACT PRICE OF WORK:$ t {. ) :, <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES 1940 <br /> ASSOCIATED BUILDING PERMIT#(ifapplicable): <br /> D CRIPTION OF WORK: k iRi-t(n5(.. . ..7-4-... ylf\ , <br /> CONTAet INFO AATtOl+II <br /> ;INNER NAME: L liff-4 <br /> TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET A r <br /> MYSTATErf* zIPt" <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: W t•- 1 <br /> CONTRACTOR ADDRESS; STREET <br /> k. <br /> f <br /> CITtt v. <br /> Y \ r, [ STATE U - ZIP <br /> CONTRACTOR PHONE- -'' 'jb i CONTRACTOR EMAI (1. ` , � „ V fri.., <br /> CONTRACTOR IX.#(REQUIRED): 1),.(-11-14 CI. . EVERETT B SINESS LIC.#(, REQUIRED): )\D9 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CO TACT NAME: CONTACT PHONE:2;• - 4 <br /> q,7177'71 <br /> tI ✓ CONTACT EMAIL: E t C j C <br /> 1697 <br /> AGREEMENT;T hereby certify that I have read and examined this application and know the same tG be tate and correct. II provisions of laws and ordinances governing,this i <br /> type of work wrilhe 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 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 298.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 1--(20 ------ <br /> '" PERMIT# <br /> 4ri \%03 E — 1 S <br /> t <br /> Ow erlAuthorized Agent nal7ire Date <br /> n 9 g (Revised t 0112/2075) <br />