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ELECTRICAL PERMIT APPLICATION <br /> dobe•.„.14...at..„.../.. CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ''iltA04,0 .01%.61r, ,f - 0#tNiATICiN <br /> ,,,,„, . 0 <br /> PROJECT ADDftESS: 4.40:) 1 - ilt nier - ' <br /> BUILDING AREA(If residential,new construction,remodel,or additton) SF <br /> BUILDING TYPE: tr,..SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI FAMILY-#OF UNITS0 COMMERCIAL <br /> ------ <br /> USE OF BUILDING: <br /> aNNde <br /> '2110,1,110Aiiik''itif)/iitiil.$1404 <br /> CONTRACT PRICE OF WORK: $ 7...5cDc° <br /> - <br /> NUMBER OF.DEVICES If Iow volt : <br /> FIRE ALARM? 0 YES ...,itillo <br /> ASSOCIATED BUILDING PERMIT#(If ap.licable): <br /> DESCRIETION,QEWORK ,.„ ,, 0 . r., ___. _ S <br /> --. <br /> 1 <br /> ., AtiaN <br /> OWNER NAME: 9 '''' a f...,, * I TENANT N E(If Oommerclat t <br /> ,-- <br /> OWNER MAILING ADDRESS. STREET . 411 I .e..r- <br /> orrf gi,eettott STATE LA-7 4 ZIP SV * <br /> 1 i.,,„,, <br /> OWNER PHONE: 11-42 Z32. Oc,2,..c) OWNER EMAIL: <br /> CONTRACTOR NAME: At A <br /> CONTRACTOR ADDRESS: STREET I 1 <br /> CITY 411°,4*.dila *...st ' STATE ,..,.... 4 ZIP *4;111 20 <br /> CONTRACTOR PHONE: 55j 095b CONTRACTOR EMAIL: detotze a)afylitie044,,ig ,to 114 <br /> waw-Eby-crit Of17 tilriltill 41M24111110111M1 CITY OF eveReyr BUSINESS LIB.#REQUIRED t ,k4II'a to <br /> --- ONTRACTOWEIC' <br /> PRIMARY CONTACT: DOWNER rii CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: L-las R5q D.556 <br /> , . <br /> I &dale <br /> CONTACT EMAIL: • tafIl inr) <br /> AGREEMENT:I hereby certify that I have reed end 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 ala 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. Thal 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 /> 1 <br /> PERMIT# <br /> 2,09 <br /> Ow"„„,..„.,ized Agent Signetuta ' Date <br /> (Revised 9/23/2016) <br />