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ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT ADDRESS: I-1 -0 `�i ekj 10-C P&G" bvL- BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: itSFR-DETACHED El SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Allik V /' T„,,,/'',4',1?,,;',7:1',:n17, /// rzi/;'// //a//:10 /% x///;///11 '`I Ov4/�/%/ // CONTRACT PRICE OF WORK:$ , 500. v' NUMBER OF DEVICES(if low voltage FIRE ALARM? 0 YES r O ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: A-14 e/At cu!''r OWNER NAME: 9T-eve- t .0 ' t vvi t4,, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4 a-0 V.�(E-14 i.(vo t`" b(� + .,/� CITY -\/ -V. l l STATE vV�T ZIP eI'c�aG 3 OWNER PHONE: gO t Sb� 45 L9' OWNER EMAIL: CONTRACTOR NAME: CIA/Q.'/0 L-LtCrL1 CONTRACTOR ADDRESS: STREET 7 Dot( ( 'O A.A.,. #,..J CITY PEA,WIOcwO STATE fV1/4/14._ ZIP y i� s• a . CONTRACTOR PHONE: p?-cam-ggs-01781 CONTRACTOR EMAIL: AT II C l f rpt e c r4 /e• CO t.. CONTRACTOR LIC,#(REQUIRED): £ /Al/i: E. 4 a-(,tAA-(b CITY OF EVERETT BUSINESS LIC.#(REQUIRED) (11770 el PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT�� NAME: CONTACT PHONE: D-c :'. r . /- • 0141k t---Lfw9�i.__ CONTACT EMAIL: �.f/, at-f, -CL€civic • c c-� AGREEMENT::I 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 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 local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / / PERMIT# gf� < g E t$L- ( c� Owner/Authorized Agent Sign. re Date (Revised 9/23/2016)