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F� LLECTRIICAL PERMIT _ACATION <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 I wvvvv.everettwa.gov/permits <br /> . ... .. • 'OuPet��`fl'� dfi�h��i"�!' - i�IN <br /> PROJECT ADDRESS: (0,00Z COI/VI &L aJ?. 1"Q. C Y\(4 a <br /> BUILDING AREA(if residential,new construction,remodel, or addition) l ZOO SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: �S\�Qy\ a II <br /> di a AT kill C �; N ilN) ®} 1(I�i LTi I1 N :.. .'`.. <br /> .:::...C�)1=1�.....illA <br /> .• L :'.._. ....Q .: .:..:..... _ ..:•... .. :.. ... .. ...:.:.: •.... . ...: <br /> CONTRACT PRICE OF WORK:$ w+t 010 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 1 [O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): d til "d 0.7 "" <br /> DESCRIPTION OF WORK: ��lacke oft S�1 G .v1 S-t'ck.k t V120 . 1 Q <br /> ter <br /> :• CONTACT;1IieiFORMATION <br /> OWNER NAME: EdvO\IaO CQf 2 Y10 e-P) TENANT NAME/(If Commercial): <br /> OWNER MAILING ADDRESS: STREET C ( Cj°5'5 E 1 Q IA. P 1 <br /> Kiv c1 004 A._ cry Kkv kACAviet <br /> STATE A ZIP 8,0= <br /> OWNER PHONE: 2o6^0ci -6 Z ( OWNER EMAIL: V1 ) �C& MCA owi0t-I r 14-1 <br /> CONTRACTOR <br /> CONTRACTOR NAME: W re----C2 <br /> CONTRACTOR ADDRESS: siReEr <br /> CITY STATE ZIP A\f <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS L1C,#(REQUIRED) <br /> PRIMARY CONTACT:°Y bWNER 0 CONTRACTOR 0 OTHER(Please Specify)/ /� <br /> CONTACT NAME <br /> CONTACT PHONE: 206 (Q p 2 ( <br /> I CONTACT EMAIL: to ck� yV��U '- ,(A� e Took( <br /> AGREEMENT T hereby cartify that 1 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 noL 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.20b WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> • iso -- f <br /> , o PERMIT# <br /> NFIA, E ' (2 Z2t - �� <br /> Owner/Authorized A n, ature Date (Revised 90/92/2095) <br />