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LLECTRICAL PERMIT AP C TIO <br /> A1.veliWY CITY OF EVERETT PERMIT SERVICES <br /> - 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 32 /4 / PQ/&-Z VE EvEe772 ATA 9$'2 / <br /> BUILDING AREA(if residential,new construction, remodel, or addition) /t D H SF <br /> BUILDING TYPE: IX-SFR-DETACHED 0 SFR-ATTACHED 0 DUPL/EX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: c%Gl le 167;/ d(�l�,t%!//%0 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 3O00. <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? El YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ��JJ <br /> DESCRIPTION OF WORK: I, I r/y /Ua.A} £is 7'-iUG727',0‘-? `'GAJ . <br /> CONTACT INFORMATION <br /> OWNER NAME: JCi Y1 if`,ll-4/2 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 32/V Vile 4zv, - <br /> crrY CAecie7'� STATE Aide__ ZIP 9c20 <br /> OWNER PHONE: 425 4f 22 -293 Z OWNER EMAIL: <br /> CONTRACTOR NAME: )--/4 b �� -C77e/e.- h L- C <br /> CONTRACTOR ADDRESS: STREET /5/6 9y/0, /J// € <br /> A1 <br /> / <br /> CITY Zak`r-- did vi7S STATE Va.- ZIP 9ga,S-g <br /> CONTRACTOR PHONE: 4/2 773- ©2 g CONTRACTOR EMAIL: \(k.(f e/eL 'i d.lie,-Crid9,77a 7,GB.4c,e <br /> CONTRACTOR LIC.#(REQUIRED): tT e/e/ 934/•x,9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) /4_ <br /> PRIMARY CONTACT: ❑OWNER 54 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: C CONTACT PHONE: gar--- 773 -e, 2 .5"b' <br /> Z-412 ccht h.d.e 1---5 CONTACT EMAIL: cia..9 e`eG ,z_i_. e.a.c m ter/ ,G 0 <br /> AGREEMENT:T 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 <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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> F :_cf„. C.CA4 <br /> c6,. <br /> C f ose c{ p , , <br /> E ($© '- f7! <br /> / PERMIT# <br /> #1, 44-- .�/�' '/- // -/- /g E i `$ ICI-007 <br /> OAutfiorized Agent Signature Date (Revised 10/1212015) <br />