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____ 0001p LLECTR!CCAL PERMIT A F'- LIICCATfON 14,0 -�- CITY OF EVERETT PERMIT SERVICES __-- 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 ( FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE:IINFORIi#lA`i'I if I ; PROJECT ADDRESS: p 'CYO 6/7;g inia 4v-e. BUILDING AREA(if residential,new construction,remodel, or addition) SF . BUILDING TYPE: 0 SFR-DETACHED 5i SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL FUSE OF BUILDING: _ - ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ a oQ. "` NUMBER OF DEVICES(if low voltage):, / FIRE ALARM? 0 YES 15010 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 5 F10,11 etre //Y.l o rni e c t 6- 7--S7`et 1- May(' - CONTACT-INFORMATION f l .::. _ OWNER NAME: // acy( TAOV,34c)v.1 TENANT NAME(If Commercial):" OWNER MAILING ADDRESS: STREET /020207(7 �j y1/1 i. - M,� CITY ZV Pe'e7 STATE ( ZIP 7g'2 6/ OWNER PHONE:e2Or�i '/ — 73 7 OWNER. EMAIL: CONTRACTOR NAME: /^(� . .. E/ems. ?! C..N.. _. .... .. . CONTRACTOR ADDRESS: STREET }9 9/ J 90? k I S 7' S r/ cm ,GIM4DISc STATE W� ZIP f 6,e)-‘ CONTRACTOR PHONE: / CONTRACTOR EMAIL: CO r C /p �`�- rope-pi-6?-17":- /' G� 7 CONTRACTOR LIC.#(REQUIRED)• /vOf c{� ?j S/Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5-99 iT PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: � CONTACT PHONE: "--&.C. 7/y� '7 a / . Cir J C(/r CONTACT EMAIL: AGREEMENT:T hereby certify that I lave read and examined this application and know the same to be true and correct. Alf 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! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 1.--S r------ j 0 PERMIT# ., / / // M7 E tq-c. k - 0 -..-5 Owner/Authorized Agent Sign '/ Date (Revised 10/1212015)