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ECT.,TRICAL ' IT LICA-11 <br /> �-ri _4' 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 /> ::.:PROJECT;SITE I FORMATIO. ..: ..: <br /> PROJECT ADDRESS: '1i3fif5 .f ‘12.11-i t1/41 I Nogt A 19 NV ' __ / <br /> BUILDING AREA(if residential,new construction,remodel,or addition) = ,�,•, SF <br /> ityaBUILDING TYPE: FR DETACHED El SFR ATTACHED 0 DUPLEX 0 MULTIFAMILY #OF UNITS: .COMMERCIAL <br /> USE OF BUILDING: VXMYL7'1/]1fl1- <br /> .:; , , :: :::.ELECTRICAL;APPLICATION INFORMATION:': :,. ' . . ':: ::;-:: <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 1A9E)(Zfr Z c- hdywi- % TO a Ut) 4' yea-,....coG,` .L( <br /> ,gi!I A . <br /> : . COINTAC''TINFORMA 'ION <br /> OWNER NAME: 0,y'wAAL /rn TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 23ciii emi jyn�5' 1 <br /> CITY STATE .111.44+ ZIP vM1 V 005 <br /> `OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: r li��L c <br /> - <br /> CONTRACTOR ADDRESS: STRE �I 3 <br /> I <br /> C(Y lit AO1:L Irja STATE - <br /> ZIP V. 0 1 <br /> CONTRACTOR PHONE: ''k 5,0W: CONTRACTOR EMAIL:APT*f\6, ' 0 tfricSITAVta <br /> CONTRACTOR LIC.#(REQUIRED) 1 ii;le...,L CITY OF EVERETT BUSINESS LIC...(REQUIRED):Y�–►g <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR 0 OTHER(Please S n <br /> CONTACT NAME: CONTACT PHONE: I— vo <br /> A-)., u, �tq,� aQ Ic <br /> CONTACT EMAIL: 1�I l l�l���i !1��/LVppil.Can <br /> AGREEMENT.-T hereby certify that I have read and ex/arnined 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 lam 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 /> FEE <br /> PERMIT# <br />