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LECTRIICAL PERMIT -4,11 II LICATION <br /> -r, <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 f FAX 425-257-8857 l (E) everetteps@everettwa.gov www.everettwa,govlpermits <br /> PROJECT SITE INFORMATI�+IV' :; <br /> PROJECT ADDRESS: C.a 7Z)...g. R &j-42: f (� <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: Ili/COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 6t� <br /> J 6O <br /> NUMBER OF DEVICES(iflow voltage): /� <br /> FIRE ALARM? M`(ES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): n I ( /� <br /> DESCRIPTION <br /> -O�^F WORK: �t'�i crn �o €C 3 tti r _ Q�I ari&& �ry S`l- c& �f'o-4- <br /> NO.Ac,J ACL C <br /> ONTA, 'I't..N...._ R. ..::T.. <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: II OWNER EMAIL: <br /> • <br /> CONTRACTOR NAME: T r c i o. '�)(7l�`L(,` y - .bhl.S . <br /> CONTRACTOR ADDRESS: STREET g(o ( ."L-�C S� tj r. <br /> CnY ^tui/..u) STATE 1.-/ ZIP ra 4,r <br /> CONTRACTOR PHONE: JO(o -'9 -43D-( CONTRACTOR EMAIL: LLQ 420Q. rov..(0Lai S r C <br /> CONTRACTOR LIC.NREQUIRED): ���d <br /> 13- �5 CIT OF EVERETTBUSINESS`LIC. t(REe�IRE <br /> D):^M 0-•9,•m`1 <br /> µ <br /> ' 7 " -� „ <br /> PRIMARY CONTACT: 0OWNER "YR/CONTRACTOR OTHER(Please Specify) <br /> CONTAC NAME: CONTACT PHONE: 3 — 07 — 1-137-1 <br /> CONTACT EMAIL: <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 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 296.206 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 20 <br /> PERMIT# <br /> \JLIJ SVI`Lide/ i IHi0t \ <br /> 1 <br /> ner/Authorized Agent Signature Date (Revised 10/12/2015) �M i: <br />