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jopp,- - ECT ICAL PERMIT APPLICATION <br /> - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I vwvw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: D L) C rt 1"3'1\ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 1 a-©O SF <br /> BUILDING TYPE: ASFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: („ s ` S l C - <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 0O0 c'`.2.-- <br /> NUMBER <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO n _ <br /> ASSOCIATED BUILDING P RMIT!tar gpplicabJ,e): � ,4 du l..- CE ✓ (J 6-,/r1 i�ty`C_ Ctr're <br /> ESCR PTION OF WORK:P% <br /> [A �( st c, Li, V Gv1,- f .i-, S J dvi <br /> ccP c1 <br /> c r ,o-,t -1-- t k a dP 0 yS fk0 v,0-6-1 <br /> c 6\,(0 .,e , LD 0 V u9 ru-it ()6-1—1--- <br /> . <br /> CONTACT INFORMATION. <br /> OWNER NAME: 5-0 3 L) f N. L_L C TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 70 ( b S 7- S C 4 <br /> CrrY (J CLp i7 STATE L - ZIP c( 9 ao 9) <br /> OWNER PHONE: ( i .-c_.1 <br /> OWNER EMAIL: <br /> CONTRACTOR NAME: � i 0-e . S , " L 1 Lfr ctc<. ..CONTRACTOR ADDRESS: STREET 2 2 k.., l CQV4l �� rt,�� C (�/ yam} C <br /> CITY 11 �7V.,W 5-Cr Ire 1k l STATE ZIP ` `F )J <br /> CONTRACTOR PHONE: ��"��11 YYY�" CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(REQUIRED): L US L CaC *Y.OF EVERETT BUSINESS LIC.#(REQUI D):Sly„ <br /> PRIMARY CONTACT: XfOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: l )S ) i O 3 5 /7 <br /> 0-(„) CONTACT EMAIL: S t-e ve C 9, r 0 fitS cm"(c.4- <br /> ` <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 an 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!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 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> iso <br /> PERMIT# <br /> ,�� Cb — � e---) <br /> E c�aS -bk. 2- <br /> IV <br /> uthorized Agent Signature Date (Revised 10/1212015) <br />