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<br /> ELECTRICAL PES' r, 'IT /1,PPUUCAT ON
<br /> CITY OF EVERE I t PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 J FAX 425-257-8857 1 (E)everetteps@everettwa.gov f www.everettwa.govlpermits
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<br /> PROJECT ADDRESS: -yo.2 5 &dS A - '7`�5
<br /> BUILDING AREA(If residential,new construction,rerrfod �el,or addition) SF
<br /> BUILDING TYPE: El SFR-DETACHED D SFR-ATTACHED
<br /> 0 DUPLEX D MULTI-FAMILY-#OF UNITS: NI COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK:$ rr 500
<br /> NUMBER OF DEVICES(if low voltage):.
<br /> FIRE ALARM? D YES NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: itaoff&t/
<br /> r•_S, .`..r.. .' «. ..r.', /»OrTAC'l<".'1�I,FORIIi 'Y'ION: - .. . s _..'r
<br /> OWNER NAME: TENANT NAME(If Commercial): /106
<br /> OWNER MAILING ADDRESS: smeerc�,R2 y,E0.)( 3707 �Q
<br /> coy .50177-LEW1 ' 3E STATE /2'/2267
<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: Ce�fF•-/t L.e,
<br /> CONTRACTOR ADDRESS: STREET yyPO eOX1,
<br /> 4
<br /> CITY )7)1 J /f!M—� srATEVVile ZIP 9g2G/C/E J
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<br /> CONTRACTOR PHONE:. 5-294-6944 CONTRACTOR EMAIL: kf�-/E1. Niffil 1Erj2,NeD/7Y)
<br /> CONTRACTOR LIC,#(REQUIRED): GENg•„ �t e..011-10 I CITY OF EVERETT I USINESS LIC.#(REQUIRED):
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<br /> PRIMARY CONTACT: El OWNER XI CONTRACTOR D OTHER(Please Specify) •
<br /> CONTACT NAME: p CONTACT PHONE: 206-'73r�J--�pS14.6,J •
<br /> D61\ 1415 6e0W CONTACT EMAIL: DE4J jS.(.Kol.t)a h I}_. I T. &o./31
<br /> AGREEMENT:T hereby certify that I have read and examined this application and knowihe same to be true and correct Ail provisions of laws and ordinances governing this
<br /> type of work will be completed whetherspecltied herein or not The granting of a permit does not presume to give authority to vlo/ate or cancel the provisions of any other state or
<br /> local law regulafing 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 i
<br /> comply with the State Contractors Law ia27 RCW and 20.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> C/9
<br /> PERMIT#
<br /> 7 / /g E (6[ D-09)13
<br /> Owner/Au prized Agen Signature Date (Revised 10/12/2016)
<br />
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