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I A <br /> !. ECTRICAL PERMIT APPLICATION <br /> 4.4 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425--257-8857 ( (E)everetteps@everettwa.gov J wvvw.everettwagovlpermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ( ?-O() j51-H <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: ACCOMMERCIAL <br /> USE OF BUILDING: �.4;vcA <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ I OO. - <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ID YES <br /> ASSOCIATED BUILDING PERMIT# if�licab <br /> applicable): <br /> le): <br /> (ec.4-r;ce l �� <br /> DESCRIPTION OF WORK: �� � i-�,� C�cw>„��ec� S154 <br /> 4 a 4-- f.Ock.eNel(tt- V C ✓vt ioLAAanec Qnl <br /> CONTACT INFORMATION <br /> OWNER NAME: Prr v c�,, IZ.c{o. ( A'tectra4 4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smeEr leo( Gi. Gil 5t c� #1:)/6, <br /> cm( Rc..rt4zoek STATE 40 zm47.E34-,S <br /> OWNER PHONE: !OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> ICY <br /> CONTRACTOR ADDRESS: STREET , .5-&14 7" A.J;c:. 5 <br /> CITY Se -tr?. STATE 4.)4 <br /> 7610 <br /> CONTRACTOR PHONE: <br /> Zea- tf3a,-s2aa 'CONTRACTOR EMAIL: <br /> CONTRACTOR LIC. EQUJRED): tireA EO-z.Sofa AU <br /> . - CITY OF EVERETT'BUSINESS UC.#(REQUIRED:60(-6-'4{ <br /> PRIMARY CONTACT: I7 OWNER 0 CONTRACTOR ; OTHER(Please Specify) F't'.(d <br /> CONTACT NAME: CONTACT PHONE: <br /> ZDV—435`t>-- "7`7.34 <br /> N SC CONTACT EMAIL, <br /> AGREEMENT/hersb_ de* � r Sc Efc,�}�„a.4.�#} Z1�'�.Gr��� <br /> of Rork will completed whetherhave read and examined this appficalion and know the same tote true and greet All Provisions of laws and ordinances governing this type <br /> pf specified herein or not The granting of 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)am authorized by the owner of this property to perform the work for which application Is made and l <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> s : ` W <br /> er/Auth• ized Agent Signature 231 <br /> Oat- <br /> (Revised 9/23/7096) <br />