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477 •ECTRICAL PERMIT APSICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ._.. ONC0* <br /> PROJECT ADDRESS: 55a-F3 10' �� C -cnr A- (Abet ,(J e3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED $SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: W..eSj C lb'C(,1 <br /> x1r,E `lll 'rAL�AIIa��r 'I�1�{ t 111Q _ . <br /> CONTRACT PRICE OF WORK: $ ••O `-b 0,Oi <br /> NUMBER OF DEVI (if low voltage): <br /> FIRE ALARM? 0 YES w NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> DESCRIPTION OF WORK: ) 1 � <br /> �=5�a PAAA --5h4F 1,J (\e_. Th0 ou-[--door uset;h <br /> CONTACT I FORM TION <br /> OWNER NAME: LOC. ,l}( I s oA TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S 15_ �/ 1 C) �t S , / �j l� <br /> CfTY c:AJ `� 1- STATE {/V i '1 ZIP C 6 C/�.�'C) <br /> OWNER PHONE:04,' ) - 955-, OWNER EMAIL: U1150 W C.o'(1/ICa) -h-C+ <br /> CONTRACTOR NAME: t<l V�q rb HtCa iInc-- <br /> �j <br /> CONTRACTOR ADDRESS: STREET (,f l��-)5 9 ( �� / � J�, <br /> CITY �LL)OO STATE 14 r"I/� j 1 ZIP ! lX <br /> CONTRACTOR PHONE: ( d'S) Si ' CONTRACTOR EMAIL: km-IckGI.Q(4 4)( k 3 b1/�t��irtq Cg,vy\ <br /> CONTRACTOR LIC.#(REQUIRED): t<1 N61SH Uj"'l I( J i CITY OF EVERETT BUSINESS LIC.#(REQUIRED):C O <br /> PRIMARY CONTACT: 0 OWNER PirCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 0-(3(A) " L C S- <br /> ChAr 5 LoA\ CONTACT EMAIL: C ta,r',S L k'..m.D S Lt.C-G.`tl .CisYY\ <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 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 /> PERMIT# <br /> 8 /8 E BOA- )b <br /> Owner/Authorized Agent S gnature Date (Revised 9/23/2016) <br />