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• /2 9 '5• (;:7'�BJ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 I (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> • <br /> PROJECT:.SITE ANFORMA <br /> PROJECT ADDRESS: 10^Z4/ &a/A/• 4.,g�' f� 3/$.'j <br /> BUILDING AREA(if residential,new construction,reor addition) SF • <br /> BUILDING TYPE: 0 SFR-DETACHED 1i 0 SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: JI COMMERCIAL <br /> USE OF BUILDING: 1jQET kEVE `Y <br /> • ORIt • • - - <br /> • - ELEtatRICi4L/4�P11.6+�AHION1�!�tlE+OFLNfA7A <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES gl NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable: <br /> DESCRIPTION OF WORK: C/41, /_tei " �/97� . f/fes <br /> /I�4� /n��'1 oz Ida . <br /> •_.. •. . = • CON'fACT. INFORIVIATION. <br /> OWNER NAME: TENANT NAME(If Commercial): $0Lf/06 <br /> OWNER MAILING ADDRESS: smesr pa goX 5707 <br /> C" e5EATf'GE STATE 1421- vfiq/2q—2207 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: e-�1cjt)EiP}t' , �'_0.)57 eue Tial <br /> CONTRACTOR ADDRESS: STREET PO1.3/oxxr4/, <br /> CITY )7)1A .IL/GZ STA E V* ZIPgg204 <br /> CONTRACTOR PHONE:426-20.4144 ©`CONTRACTOR EMAIL: k�'je/. I�frm/I�Ej'e ?ki1 w'�', CDn <br /> CONTRACTOR LIC.#(REQUIRED): gEitiE 'CCS D dio Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED):040 LJ <br /> „— <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: ',/ CONTACT PHONE: 204,-73 -4544) <br /> �? <br /> M <br /> D NI5 C&'W CONTACT EMAIL: DENA/I^jCgQ(,(J® kIEt4/!r, d.o/vi <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this <br /> — etworkwitlbecompletedwhethvrsperifiedherelnornot: The-granting-ota-permirdoes-not-presumelo-give authority to-violate-or cancelthaprovisions-of any other state-or—local law regulating construction or the performance ofconstnrction. That!am authorized by the owner of this property to perform the work for which application Is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE e <br /> PERMIT# • <br /> -/7 E l�l 0P-r73 <br /> Owner u or zed Agen Signature Date (Revised 10/12/2015) <br />