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4E77 LLCTRICAL PERMIT APPATION <br /> 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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ;:,57(27 ) / 5� S <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE:SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> %Oj/j 00 /Yg <br /> j%/��j j%� 4 � 1 <br /> /^� ^�i '� 9�3;� �;�� �£�1/.�1�;� i� is�� Ti ON ' /,,,,. . ,,:.r ,. <br /> r�. <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 4/6' G/a-U/7 <br /> irn I. n2 <br /> CONTACTINFORMATION <br /> OWNER NAME: .2i6E-G'-G":. .<[/1(W(-(T TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /�-S20�'7y a(4+ t <br /> CITY �ti- �- `"- STATE `16 ZIP'�j <br /> OWNER PHONE: -J 3•-37(�' VS() OWNER EMAIL: <br /> CONTRACTOR NAME: L Jam' n �Zt (IZC.-t <br /> CONTRACTOR ADDRESS: STREET Z <br /> A.)L1An t 'O ,p /i./2 91262S-2--- <br /> CONTRACTOR <br /> CITY (i A4407`1) STATE177- ZIP 1 �L <br /> CONTRACTOR PHONE: y Nk5-c_so CONTRACTOR EMAIL: 1/ {( g_(•rf,Edairbc.7 c'C Cc, <br /> CONTRACTOR LIC.#(REQUIRED): t i(V -7 - `l Z Lr✓i ZJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):I (, -7c. <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT:I 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 type <br /> 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 I 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 /> / PERMIT# <br /> 4/7 <br /> f��l� E \ -\ 3 <br /> Owner/Authorized Age"•..tug Date (Revised 9/23/2016) <br />