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,�--- ELECTRICAL PERMIT APPLICATION <br /> CITY, F,E E--REIT PERMITu-SER ICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 f FAX 425-257-8857 ( (E)everetteps@everettwa.gov( www.everettwa.govtperrnits <br /> ottazie0/41TE-4 -14014 <br /> PROJECT ADDRESS 4QI, 1i► <br /> x _. <br /> BUILDING AREA of residentief,new..oristr uctjon,remodel,oraikii: :. <br /> :.: SF <br /> 3UIL.DING TYPE: 0 SFR DETACHED 0 SFR-ATTACHED � <br /> L�. �J. lr_�x ©4iJ[.Ti FAiw11LY /#Or UNC. 0 COiLfNfERari <br /> USE OF BUILDING; <br /> A , .. <br /> , 4 : ttf 414 . ., <br /> �' <br /> CONTRACT PRICE OF WORK; $ <br /> NUMBER OF DEVICES f low volt • <br /> FIRE ALARM? <br /> 0 YES NO <br /> .. -;�::... <br /> ASSOCIATED BUILDING PERMIT#(1fpi*able)m. <br /> hf fps. a <br /> PV <br /> .._ — <br /> ' s <br /> OWNER NAME Afk...r: 0.4. ; a <br /> TENANT NAME tg Comtnerctls <br /> OWNER MAILING ADDRESS �.Titc,T a4+ <br /> OWNER PHONE <br /> t"ON'' ,;ft)RNAME: ... ik <br /> ,. <br /> OC NTv:. amt.,AlppRess:, <br /> CONTRACTOR PHONE: STATE A ZIP ';1• <br /> ' Q fRER)i tor' � v d� t-` � � �,� <br /> I 'CtSI�EMAIL: <br /> PRIMARY CONTACT: r ttikmg <br /> C 'O' Bt1'3 $�� .REWIRED > eAmmit <br /> I7 OWNER i CONTRACTOR 0OTHER(Please Specify) <br /> CONTACT NAME: ONTACT PHONE: <br /> if le CONTACT=EMAIL ; r/1 , <br /> AGREEMENT.I hereby certify that ;have read and examined this application and know the same to be true and Correct. All provisions of laswanordinances governing this type <br /> of work wiN be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the <br /> local raw regulating construction or the performance of construction. That 1 am authorized by the owner of this propertyto perform'the work for which application is made end I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. provisions of any other state or <br /> P <br /> City of Everett Official Use Only <br /> PERMIT# <br /> guttiti10 . 3o. I E <br /> Awned :Pio togtAgent.Signature <br /> Date ,. <br /> (Revisad9/23/2076) <br />