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E!ECTRICAL PERMIT APP!CATION <br /> '1411W7' <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ... _... l ,, ._,. .nt_vl.._�..,....a.... > _u.. At.:?az:,s�..0101_.,.,.,v�.�.00. v..,m:�*... 1 .._ .. EIMc,....,.:.A._. EM <br /> IN <br /> PROJECT ADDRESS: 9 PeG./S `D}' <br /> BUILDING AREA(if residential,new construction,remodel,or addition) .500 SF <br /> BUILDING TYPE: 0 SFR-DETACHED CKSFR-ATTACHED 0 DUPLEX <br /> 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Ir45JC(ek 71-iq / <i.rt YZt liYtl l <br /> 1. tE N" O! ', to ?: 1 - '"n MItiMr? jl M F Nl` 0, l4,4,\::#:';'ANIA0M .iv Pf' .,,4e.. <br /> CONTRACT PRICE OF WORK: $ 4)/ Dov <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ONO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: kerne,ye /i2e..,oi&.C� 1 <br /> aac'c a .e �' ✓i Ge. CO .S cLe. o I cl-k,& <br /> rtel4 p co-LA-C, <br /> CONTACT INFORMATION <br /> OWNER NAME: Jen /91a_(- r cc ch a v-/) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3 ' y'Pe,' es PK- <br /> CITY <br /> � I ' 9�J/� <br /> �y CIITTY Ver 1/ STATE k-U ZIP Fez 3 <br /> OWNER PHONE: D 17- ?el 3 — OWNER EMAIL: 4/72A _,,,chP(/ Gc v CO <br /> rel <br /> CONTRACTOR NAME: Sc I t4c art <br /> CONTRACTOR ADDRESS: STREET Po 30?(' 315g <br /> CITY /9-4 t jL Q h c-i STATE I-V// ZIP q'g .a I <br /> CONTRACTOR PHONE: (0 3O 7Y y` -/) CONTRACTOR EMAIL: V?ekt,t e Sole- Peciv;c ` c <br /> CONTRACTOR LIC.#(REQUIRED): Sot-e 611-,E64-1 <br /> L 64f 2 D2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT:XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 17 -213 0(SLf <br /> J o 0 K 11 CONTACT EMAIL: 4ma C 2't die)/ ( , rfu Q d - C L) <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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> -��-� EiBM/ t '7 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />