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ILECTRCAL PE MITA JCATON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov] www.everettwa.gov/permits <br /> SI Y E 6 FORINIATpOliti/ . .. <br /> I PROJECT ADDRESS: L 2 / /./^ /r6 Ci <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 71 0 00 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECT :1CAL APPLICATION IIN FOR6ite4`6ION <br /> )'CONTRACT PRiCE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? 0 YES 0 NO ' i 1 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): C1 W Its 02.- 0O3 <br /> l DESCRIPTION OF WORK: ..e f 'YS-cc) Or" ( I 10 -t V I(JOJ <br /> 0 till 11K r t v G, L z fir / o <br /> . .:: . :CON'tl`ACT;IMFORMATIOM- _ • - <br /> X OWNER NAME: g j C X A rd / 7 i 7 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> X CONTRACTOR NAME: 0 i— /1 -4 <br /> CONTRACTOR ADDRESS: STREET • <br /> err, STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQUIRED):,.... ^^ �.., Fw ` ._..n Myw`ry ��µ„CITY OF EVERETT BUSINESS LIC.#(REQUIRED);sm ^RYmKyyni <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGRFFMENT.•T hereby certify that!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 t am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> [FEE <br /> 00O <br /> PERMIT# <br /> x F t' 01 Oo3 <br /> Owner/Authorized Agent Signature Date (Revised 10/1212015) <br />