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47T ELECTRICAL PERMIT APPLICATION <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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 6602_ JQL,ipp ta•l/✓ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: irst COMMERCIAL <br /> USE OF BUILDING: iitiscs72a) LdV/,06 CC C'iplz... <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? $YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 1`?4 <br /> DESCRIPTION OF WORK: r. IC,,te_ Z pests nED j '#'. Ces CQsa'rAPE72C/r11G, <br /> • <br /> CONTACT INFORMATION <br /> OWNER NAME: /// DLSOAS a ,., y TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET RP ock31609 <br /> CITY 4ie3dy E, 1444 STATE 4.49 ZIP 98/03 <br /> OWNER PHONE: 24.6/49. 5' 35 OWNER EMAIL:"Iara#0074504.) Q-/477-00,9jG • GDK1 <br /> CONTRACTOR NAME:.01152:7 L OY\ � Z� <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: Old,OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:!' CONTACT PHONE: ASAP..5555" <br /> /Old ,'f, . .) CONTACT EMAIL: ..)•1f74p7 4 44L •LrQ�7 <br /> AGREEMENT:T 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 <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 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 /> FEE <br /> Ar " _ `1 PERMIT# <br /> sso <br /> /7 E 1703-( gg <br /> ` •` / 2/2 <br /> Owner/Auth:. -•Agent Signature Oat (Revised 0/1 1 015) <br /> i <br />