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ELECTRICAL PERMIT APPLICATION <br /> NmigCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I vwuw.everettwa.gov/permits <br /> PROJECT ADDRESS: I I 17 P -i gt_.. ,4✓<_-. 6cs)- Ute• <br /> BUILDING AREA(if residential, new construction,remodel,or addition) >t()QC) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED lit,DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: )i v i by <br /> \ k kT 3Mx : Y E Ftilirtd lttCAt4AS ill dill A k {-, �� S • <br /> �`}'t`., ? : 4 <br /> 14F = v ,.W > 44�' <lz i s ,*.c C.�,. .aha,;.yak. g• N. .-;.0 ._... ',a,,.= <br /> CONTRACT PRICE OF WORK:$ 3,C <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ANO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Al --- Ct'''ct,' }S -L— nc., ) , k; e,,,D Suil)- -, Aul®t b ( ) <br /> >_ CONTACT,INFORM ITION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: On ...s,-4_ g-6)''-'c- ,GLC- <br /> CONTRACTOR ADDRESS: STREET ¶S(23 3'-)g" ,&,e. TIL 60.k. L-3€3 <br /> CITY r / Sv Mc__ 1 STATE LAP- <br /> ZIP al f 2 71 <br /> CONTRACTOR PHONE:1 2S L -7375 CONTRACTOR EMAIL: 0>75s Ld,1c�1)^,t 11lC. op. , cJ^x.; Leo"? <br /> CONTRACTOR LIC.#(REQUIRED):SIT EESE MBA <br /> BA JCITY OF EVERETT BUSINESS LIC.#(REQUIRED): �j) 7 <br /> u�. .. .,.,.Z <br /> PRIMARY CONTACT: ❑OWNER IZI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Scot)' CONTACT PHONE: X123- ZDt^73 7 <br /> CONTACT EMAIL: <br /> 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 <br /> 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 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 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> >> s�l� E 1(61, I- On <br /> 9/23/2016 <br /> ner/Authorized Agent Signature Date (Revised ) <br />