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Ir <br /> 'IjtfltilIllPP:;:::A. <br /> ELECTRICAL PERMIT APPLICATION <br /> - - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT WA 98201 <br /> (P)425-257-8810 1 FAX 420-257-8857 1(E)everetteps©everettwac.gov I wEww,evereftwagov/permits <br /> PROJECT SITE INFORMATION ,., <br /> g PROJECT ADDRESS: //t 'ti <br /> J <br /> BUILDING AREA(if r idential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: EI COMMERCIAL <br /> USE OF BUILDIN <br /> ' ELECTRICAL APPLATIONINF MA ION <br /> CONTRACT PRICE OF WORK:$ t , t <br /> NUMBER OF DEVICES(if low voltage): �.'T` . 7 d f° <br /> FIRE ALARM? D YES $ Nt7 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ,o t G1lC ' 0lets.c -' I2L� h .._ <br /> 1-16 <br /> f___ _ . <br /> CONTACT INFORMATION <br /> OWNER NAME:t. TENANT NAME(If Commerotal)s <br /> OWNER MAILINGADDRESS: si aET 51 t ,-- '(tIi A ✓} <br /> CITY .STATE (,�{ J,, .,y. 4p /let <br /> OWNER PHON <br /> E(..- <br /> z4g peelOWNER.EMAIL:jestAki 40,6 z ki ei, <br /> CONTRACTOR NAME: (.r 4761 .) A<_ <br /> CONTRACTOR ADDRESS: STREET 2-( <br /> GrIYSTATE t PI <br /> CONTRACTOR PHONF ctzc) 2.0-Z.- E(J -- CONTRACTOR EMAIL: k.to tit re2 '4 !?tcA.POP1,vt. <br /> CONTRACTOR LIC.#(REQUIRED): e( ' %f c S ; CITY OF EVERETT BUSINESS LIC.#(REQUti EDI: <br /> PRIMARY CONTACT: 0 OWNER ONTRACTOR E7 OTHER(PleaseSpecify) <br /> CONTACT NAME: 'CONTACT PHONE:t. I c ci06-2--F//44 .. 2 ,072,z, <br /> 2, <br /> iii.scyttb CONTACT EMAIL:. <br /> AGREEMENT:therebyCertiiy that I have read and examined this application and knowthe same to be true and correct All provisions of laws and-ordinancesgoveming this-type <br /> of work will be completed whether specified herein omit The granting afa.permit dines not preemie to fl v suthority to.violate or sense l the pitWisions of any other state or <br /> locallaw regulating construction or the performance-of construction, That l amauthorizedby the owner Of this propertyle perform'The work for which application is--made and <br /> bornj y with Che State CpntracterE LaW 18.,27 RCWeed 296.2e0 WAC. <br /> City.of Everett Official Use Only <br /> PERMIT# <br /> iL„,.... C... 7.,,A i - -r E\ 22 22L) <br /> ovoier/Autkoriz+ed,A nt Signature Date ((evlieed 9/23a01¢) <br />