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"pp_ <br /> ILEO ICAL PERMIT APUCATION <br /> Nima. - 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: /a/2/ 7 mos - - 90'2-0 V <br /> BUILDING AREA(if residential,new construction,remodel, or addition) NM SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: ./../t 57O IAC./l <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 3ccO" 00 <br /> NUMBER OF DEVICES(if low voltage): 4./A <br /> FIRE ALARM? 0 YES IR'NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): NM <br /> DESCRIPTION OF WORK: e4, b)Nt- SScq /w/ filTHOW 140-/Aio— <br /> CONTACT INFORMATION <br /> OWNER NAME: , sWuWI 3702,44 micen94EAV TENANT NAME(If Commercial): M4-/0,M00b ` r <br /> OWNER MAILING ADDRESS: STREET . ,9'6 :23 3,Com+b. ^� <br /> cny F+!'�/l.7E..... �,7 STATE `ZIP 9 1 rZ <br /> OWNER PHONE: 1/75--- 2 S`g- _.32.3 OWNER EMAIL: L YAM/®50a/V1-00,3460,9 1T- Cif <br /> CONTRACTORJ /�/,e' <br /> NAME: S7* <br /> CONTRACTOR ADDRESS: STREETf I['�E s� O 4 SAV <br /> - ` <br /> cn- . thSTATE 09 ZIP 9(20/ <br /> CONTRACTOR PHONE: ViS`Z6e-7403 CONTRACTOR EMAIL: Na026/1/4/056® Jou ER COirk7 <br /> CONTRACTOR LIC.#(REQUIRED): PIP4rce..71/ZQ. CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ("//tek3 <br /> PRIMARY CONTACT: ❑OWNER gd•CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 245 g' Woo 3 <br /> 5eo)°r ('/ //V 5 CONTACT EMAIL: (;)i R U)S'6 e EgovN „- coy <br /> AGREEMENT:T hereby certify that 1 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 tam 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 /> ( <br /> PERMIT# <br /> 0//// ELia a - © 7 4f <br /> 0 = zed A.1nt Si•nature Date (Revised 90/92/2095) <br />