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@4477 ELECTRICAL PERMIT AP LOCATION <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 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: if 0(z2,:5 tor d i 4v <br /> BUILDING AREA(if residential,new construction, remodel,or addition)ZPSS /i 00 0 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED- 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 4 pr r�--Carr <br /> LECT CAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: 51 0 00 <br /> NUMBER OF DEVICES (if low oltage): Cr;h/7- �� ALta/le <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 47' &Pelt 06 t / 80 l 1i C.v7Ti/ f fc/f <br /> CONTACT INFORMATION <br /> OWNER NAME: G w 0/g../ fVi y f(,,5,97i TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ( 0 /}\�j flu err , a.1 J4' 1' <br /> CITY (:#1?rP STATE 64.' ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: /VO) / g/,o,Tf e: c <br /> CONTRACTOR ADDRESS: STREET /7 5 ?j pt_ 41-u t71 <br /> CITY 6071/x// STATEC4/P/p�. ZIP:''n G <br /> a <br /> � <br /> CONTRACTOR PHONE: G/ � 'l(f s ��,� CONTRACTOR EMAIL: jo,4 !f.A 614�,oG,(c 7 G j,ic ! v <br /> CONTRACTOR LIC.#(REQUIRED):fr 4 f .e j .ifoo.Q/ CITY OF EVERETT BUSINESS LIC.#(REQUI• D):S <br /> PRIMARY CONTACT: 0 OWNER AcONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 4-1,1-5.L CONTACT PHONE: L//f5 j e( <br /> (�(14 " f l` /�Avt l v rift CONTACT EMAIL: at <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 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />