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-kLECTRiCAL PEW\JrAOPILiCATIION <br /> -j 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 /> . PT•,:i.):4001--$04 IINFOR1-00li r - . <br /> PROJECT ADDRESS: ilk" f' 3 5,(1<6-2 04. 6kec64.72( 840 3 <br /> I BUILDING AREA(if residential,new construction, remodel, or addition) 3(.0/762 s <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DU' .r • ULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: e,/ <br /> IMECTRIiCAL APPLICATION INFORMATION <br /> CONTRACT PRiCE OF WORK:$ / (p o <br /> NUMBER OF DEVICES(if low voltage):, &5 <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if aoplicablle): <br /> DESCRiPTION OF WORK: T1L <br /> ' —IL. k <br /> 0 € - ,S---1 <br /> , .. <br /> J.---, - :, :-: ' : - - ' ,,_ : , CONTACT iIdFORMATION. `. <br /> OWNER NAME: A rp-r e• L.c,/4 arzei"1L,fattiO NA <br /> OWNER MAILING ADDRESS: STREET SA-71-- AS jc71.Cc:� <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: S tAiUiif'.r-rlf` (5iee 4L-etre- <br /> CONTRACTOR ADDRESS: STREET 4,,,T 3 Lr--11't <br /> �—,+/ 6 ) /9 `(: ki.� <br /> CM' r� hi CS/Zi�"'—i"1%.., STATE 4,4 ZIP VS( 7 /i� <br /> \ <br /> CONTRACTOR PHONE: Z.0 4,2 `S---ti(g# 3 7 7‘:. CONTRACTOR EMAIL: \ <br /> CONTRACTOR LiC.#(REQUIRED): (A- StC� 1 C. 0 PO CITY OF EVERETT BUSINESS LIC.#(REQUIR ):..--,- ---_____-___„..../ <br /> PRIMARY CONTACT: ❑OWNER yrCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: b vAtn CONTACT PHONE: 7.4.0-(e j„ 77 <br /> K CONTACT EMAIL: �C' <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 <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 l 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 /> FEE <br /> PERMIT# <br /> ''�r► 8- 3 - E sos oz9 <br /> Owner/Authorized Agg ture Date (Revised 10/12/2015) <br />