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477. ELECTRICAL 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 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> `PRO4EC`'1";OiT Pirittl -1011 <br /> PROJECT ADDRESS: <br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ti-ter RICALPA ;P $ 1 'lOPr tkiii0010 ON <br /> CONTRACT PRICE OF WORK: $ ,°C <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): , ( �,,_t� <br /> OFSCRI lON OF WORK: _415-fait ,a_e_r _i,.`,`.___0 J ie-f- <br /> OWNER NAME: JwJ 4 / 11`'fVl / TENANT NAME <br /> ( <br /> If Commercial): <br /> OWNER MAILING ADDR S: STREET ."."10 web4- KAU 'N o ad <br /> I TIT <br /> ST ( 7ll20; <br /> OWNER PHONE ,O47 44247 'OWNER EMAIL: <br /> CONTRACTOR NAME: Crn <br /> CONTRACTOR ADDRESS: STREET � ) �J W0 <br /> �--� CRY ..'y ��4+f"SLl1 STATE Viti'T ZIP (1'8 201 <br /> CONTRACTOR PHONE: Lo t °Cb (CONTRACTOR EMAIL: eblVi e a C Y1kl634+:1 frtgco YY'? <br /> CO. .CTOR`CTCT#(REQUIRED@: <br /> id CITY OF EVERETT BUSINESS LIC,#(REQUIRED): Ite0 <br /> PRIMARY CONTACT: 0 OWNER laCONTRACTOR Cl OTHER(Please Specify) �� y <br /> CONTACT NAME: ����((�� CONTACT PHONE: Lf 6 959 D <br /> 1 'e able. CONTACT EMAIL: deb;1 . int.= •CeY <br /> ll <br /> AGREEMENT:f hereby certify that I have read and examined this application and know the same to be two end correct. All provisions of taws end ordinances governing this type <br /> 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(he work for which application is made and I <br /> comply with(he State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> EOwneriAttttlQrized Agent Signature v O 3 OLP\ <br /> Dale <br /> (Revised 9/23/2016) <br />