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. <br /> . i a"il KYi.i.4( 114, <br /> ..:-CAL ir:21 A4 -* „,.:, <br /> A000., <br /> . ELECTRICAL PERMIT APPLICATII,.. <br /> 're � CITY OF EVERETT PERMIT SERVICES <br /> 32.00 CEDAR STREET, EVERETT,WA 98201 .. <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION. '. - ' <br /> PROJECT ADDRESS: q 1 tr7 ?ACI lc tC. Ave . <br /> BUILDING AREA(if residential,new construction,remodel,or'addition.) .. _SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#QF UNITS - 0 COMMERCIAL <br /> USE OF BUILDING: <br /> .,ELEC 1 4i1li 00;1i1111f�ItTt+,D•11I <br /> ...... .:. .. .. .... .. ... ...... ..: <br /> CONTRACT PRICE OF WORK:$ 4 is 9$ <br /> NUMBER OF DEVICES if low volta i e : .. <br /> FIRE ALARM? DYES ANO . . . .. . <br /> ASSOCIATED BUILDING PERMIT#Of applicable): . <br /> DESCRIPTION'OF WORK: 1.3s'tlli.i_ Lot)..:i ucOt_-rAGE S C.kaP€'T t q.sra(n • SEA -1(o ri <br /> LoADi10 MCP- 0• . . . <br /> • <br /> OWNER NAME! •pp... 1114044* TENANT NAME.(If Comme►eial); <br /> PO 80s, 1O "7 <br /> OWNER 1ti1i41LIN.G/4QI)FtESS; mar .. . .. ....... .. <br /> 14.1 : r STATE W A "'[g2Q ? <br /> ;OWNER PHONE: .4.-t $-74,1-,Tact f 3 OWNER EMAIL: <br /> •' ONTRACTORNAME. Aet)io w 5 ('>011T 1 ?. <br /> .:CONTRACTOR ADDRESS; sirsa? (OQA E5OAL E A)1.z_ S <br /> oily .p:.. /.31-01.,-) STATE ( !`'i .. ZIP . Sto51_;..., <br /> CONTRACTOR PRONE.2:Cci,,-2 `I=..3::75 3 CONTRACTOR EMAIL:PA L-:iliac 2'Sio ti' '). <br /> iN. k: CI Y E E'�• <br /> 6ei. .: . ... <br /> • <br /> • <br /> CONTRACTOR LIC.: EO <br /> #(RUI.t2ED):A cots&0..1 C CITY OF EVERETT BUSINESS.LIC,.#(REQU1RED:'Q31 .I s 7, <br /> PRIMARY CONTACT: 0 OWNER .0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE 20,c;, .2.45- ( `'I Li ( . <br /> CONTACT EMAIL: PAUL+Ar'z..OI�LSl,ll r 2c0:vSC4uSEC'"I i7 7, e CM <br /> AGREEMENT'T hereby cetfify that I have read and examined this application and know the same to be fare and correct. All provisions of laws end-cud minces governing this <br /> stale or <br /> • <br /> type of work wilt be:0:n000:Whether specified herein or not- The granting Of a pent*does not presume to Ova aufhotity to violate or'cancel the provisions of anyother <br /> ' <br /> local lain regulating constinfct(on ortiie performance Of comb-pc-lion. That I am authorized by the owner this property to perform the wax far whicheppiicebon,is Merle and! <br /> ci>rrply-with tare Steto Cont acfors Law 18:27 RGW and'296.200 WRC.. <br /> City of Everett Official Use Only <br /> FEE <br /> Or <br /> 14 <br /> I 1 / y /+ PERMR# <br /> k ..') (L - . E f 11- IZ� <br /> D.wnerlAuthorized Agent Signature Date (Revised 10/122015) <br />