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ECT ICAL PERMIT AI" -ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 ( FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits .t. :.. • • • • ROJE S1T�•:II�F®Rt#tIAA,'�I®Al • • .. ..:- .._ _, ..:... .. __. . - .. . .. ... PROJECT PROJECT ADDRESS: 3/ g „✓� c-) V(,..... b"-/ - / 61-16- BUILDING AREA(if residential,new construction,remodel, dditio d l� SF BUILDING TYPE: 0 SFR-DETACHED 'SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: • - ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 30-00 • NUMBER OF DEVICES(if low voltage):, FIRE ALARM? 0 YES 4O ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: F,w,0e2 L.4014.6D E /4,-4D (./..../p.--t../ 41eM1 4-DO/7--/6-3 O N TACT.:I N ORIVIIATIO N OWNER NAME: C -c Jt'JJ CAA/t A-Nct°,J� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET `21,� C N.LI,vJ ) v6 crr E V(-A-€ STATELlet- ZIP OWNER PHONE: 1/0.26---3'7 te—qq 0 9 I OWNER EMAIL: CONTRACTOR NAME: I S l<y L�(= 1`n-lc- l- (©. Tf.A-rcj �S bt. .i . LLCA CONTRACTOR ADDRESS: STREET 1 C,242,0 9 a-igitl t_ RD ,, // c v4' - ,5/7.6 STATE '42-- ZIP 9g `g p2,s CONTRACTOR PHONE: /:2r-76 o -v2(�,02� 6 CONTRACTOR EMAIL: �z A)r-s-Xy :1- l c. -' P .,+I i . a cO -, CONTRACTOR LIC.#(REQUIRED): 5/YE-.5 EGErg aG 6 CITY OF EVERETT BUSINESS LIC.#(REQUIRED ��/� e_ PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: $)( =7 t O v26a j— jFE� , ___ CONTACT EMAIL: cZ '/t�E: 1 ,0CLC X-tG_)t!�e; +q,,_.C�,'�,, AG ENT:: /i� s , 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 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 local law regulating construction or the performance of construction. That tam authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only FEE . k7 teu�� 0, ., ,. PERMIT# - Ow •r/Ruth. 'zed Agent Ignatur to (Revised 10/12/2015)