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3 <br /> L CTRIICAL PERMIT PlitLICATION <br /> `: CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)42E-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwa.gov I www.everettwa.gov/permits <br /> e „ ' <br /> I1101 ': 11�1 1(.. 1 �_1. .:.:_6TI'liW' :. : i:7:I. <br /> PROJECT ADDRESS: AL'/4U`, /"G`'/L/, 6/'/‘-//✓`� ,Ic / "V2.. <br /> BUILDING AREA(if residential,new construction,remodel, or addition) / SF <br /> BUILDING TYPE: El SFR-DETACHED El SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: N.COMMERCIAL <br /> USE OF BUILDING: <br /> : : .ELEPTRQCA IL ,,PPL Arf' NF . MArg r' <br /> CONTRACT PRICE OF WORK:$ tfolvz2fiErA,at j 0 a /4-/vef) #1420 o <br /> NUMBER OF DEVICES(if low voltage):' <br /> FIRE ALARM? D YES NO / <br /> ASSOCIATED BUILDING PERMIT#(if applicable): /U/A <br /> DESCRIPTION OF WORK: 6'- i -/- i- /o yj e l/ ' () ..4 <br /> 7/..4/q <br /> ciA ..S fj 4 e /e. gr,,:�o E4.9 'r /2-0/2 i C> / 5 <br /> • <br /> .• :: - 0N`d`AC'[.10.FOR8tI0.ON , _ <br /> OWNER NAME: TENANT NAME(If Commercial): 6 oat / <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �7/f / /e.G.r2.� _. --s-- <br /> CONTRACTOR ADDRESS: STREET ,OS-V9 b q <4//6, Pte- •f'E- /49th !/F'�A-y / <br /> CITY ,/�2f/�//' 14, -t STATE 1,0, -- ZIP 930 33 <br /> CONTRACTOR PHONE: .g0 4-570-c{O/© CONTRACTOR EMAIL: .J-R. E L E(0n ..5-7V. .o 114, <br /> CONTRACTOR LIG?(REQUIRED): 3(2 6 i_. ,T s D 2 IQ _ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):._.-__._r._xr...�..�T x <br /> PRIMARY CONTACT: L7 OWNER ¢CONTRACTOR uM1l]OTHER(Please Specify) <br /> .,. <br /> CONTACT NAME: CONTACT PHONE: (, -- 5-7®—VO/ <br /> `r1'I <br /> t lin- �.I /) CONTACT EMAIL: /o L G &/YJ. A/' e6/24 <br /> AGREEMENT T hereby cerIify 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 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 RCWand 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4k:::) 1., 2 <br /> PERMIT# <br /> dr 0 4se'/44.44.--) <br /> ele) /0 -.2-i7- Cill, b- nI3 <br /> iwnerlAuthorized Agent Signature Date (Revised 90/92/2095) <br />