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0.400. !LECTRICAL PERMIT AP LIGATION <br /> I�►' 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.govI www.everettwa.gov/permits <br /> Plto�lECT <br /> stirtiNFOitinAtteitsi <br /> PROJECT ADDRESS: /0 / Z-/ j�7� 41(E $ <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: COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ )QQD • <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? 0 YES ROO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTIONOOF WORK: __PiS4-OAUNNG7' e ) fs7/ii/6 �/t L l �t Pk - 5 <br /> /971/b /?c iivcc] r (`f) A)Fki) rJ v A57 vs� 5 _ <br /> CONTACT INFORMATION. <br /> OWNER NAME: C/'f�r(eetu TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /O' ) 11'64 4v 4 <br /> CITY EY "Y/ STATE w4 ZIFz-0, <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 7./Z(^ /VI <br /> CONTRACTOR ADDRESS: STREET 35' j •,1g77"` G <br /> CITY t,4 eG !01?5 ` / A STATE •� 18/5-3ZIP '8/ <br /> CONTRACTOR PHONE: Jac.- 7n- 46 77 'CONTRACTOR EMAIL: "tri,44.e/thr,GQ g2 4 /eY crn4" <br /> CONTRACTOR LIC.#(REQUIRED): -Tki > 1 L.�F �j'etp CITY OF EVERETT BUSINESS LIC.#(REQUIRED): S-J�I7 8 <br /> PRIMARY CONTACT: ❑OWNER Ar6ONTRACTORwv 0 OTHER(Please Specify) <br /> CONTACT NAME: 1 CONTACT PHONE: j175--..-7-7 4677 <br /> CONTACT EMAIL: -to yeledste/C04(dOdey;; /11/0 <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/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 /> 1 '6O7 -135. <br /> Owner/Au . ed Agent Si;na ure D e (Revised 10/12/2015) <br />