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.LLEC ITRJCAL PE*MIT A ICCA il®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> SITE IIN <br /> PROJECT ADDRESS: (pgt 4 �-RV-S•11-)RE V E- <br /> BUILDING AREA(if residential,new construction,remodel,or addition) I' 42O SF • <br /> BUILDING TYPE: ' SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING; 51 N CjL F'S'M)L-4 OM' <br /> ELECTRICAL. <br /> CONTRACT PRICE OF WORK:$ -- <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ID NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> • DESCRIPTION OF WORK: TtAa to 1Ril3t& � fl-bb Curuiiv3 <br /> R Ec PrCE eini)-(N rtan6CT toy 1,3Dig too A > 020&4 <br /> .: . . . : . .. . <br /> • <br /> . ..;... . ..: ..-� : :=.... . .•:CONTACT;INFORMATI®Id- .:.: . ... _ <br /> OWNER NAME: ilbftkibMietV TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smear 6go6 f31i_si-}'tR 1)R1 <br /> CnY E.V`zG—n— STATE IVA ZIP 9 9 Dg03 <br /> OWNER PHONE: 853 797 bovi k��p OWNER EMAIL: <br /> CONTRACTOR NAME: .... .. �_' �, �^lV iZ� ,. ... . ....... <. .. , .. ... . . . ,. . . .. ... .... .. ,.. ... .. <br /> CONTRACTOR ADDRESS: STREET (,J(� • <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: -- CONTRACTOR EMAIL: �^ <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> :... �: r. :, _,,.,.,.:..�,_.: .,::. w.,,...,.. ..� ... ...........r .. . :.,. ,.:.:.:.—,ww. ... _- .,:. _, :w,_ <br /> PRIMARY CONTACT: [OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <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 l am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 130 <br /> 114 <br /> PERMIT# <br /> 4).343W (6//sora F I �Zbi <br /> Owner/Authorized Agent Signature Date (Revised 10/9212095) <br />