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04Tr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �± /� <br /> (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everet wt.MGINAL <br /> 1,1411';': <br /> r yti"�U 7 } '1` wd-4 '.. �'n- 'y r f "hs - q'r i Oltoatetlty '` Jyd4 �' r iy.' r y;'�,p° 3 r, ��J N@- J J i� oyr,o,i'3. ,,,,,1* <br /> PROJECT ADDRESS:IS051 h ..0 1k-e,r is-(9, <br /> BUILDING AREA(if residential,new construction,remodel,or addition) Y, 1 / af SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> y Spy h' ;,' - i{*J* i :ii ,-4 ' r .i a� T O '` i rtF ' ra4 e si !a ,i-m„ 1 ,, a �i , <br /> -. .� ,: �.rex o .n ei Ce s , �,n.a„i4 �. C[N t %u..=im i'g'�lii tom#, .rin m,-y a_ crop-.x.- _. - <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMI #(if applicable):li <br /> DESCRIPTION OF WORK: CiYCU(H 4kr /VC 1/153411 <br /> I <br /> 1 <br /> CONT�ACT�INFORMATION . <br /> Li <br /> OWNER NAME:3taarl /ii It , /,((/d TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1'� LZ--�"'�OltiI — aZt / _ <br /> CITY E�/Pi�,gt+ STATE t N ZIPggz/ <br /> OWNER PHONE: NZ5–.11Z_ 16 OWNER EMAIL: — ��'111 VVVVVV <br /> CONTRACTOR NAME:-Flue Frame - <br /> � <br /> CONTRACTOR ADDRESS: STREET�j�/ /l,�//��j III <br /> C5 �;/C/ � 0/ 9�//� f <br /> L <br /> CITY ' ` Ori f 1'Y 11( T rr l l t STATE ZI 6'U,/`/ l <br /> CONTRACTOR PHONE: I — `71 CONTRACTOR EMAIL:i1�1Q f,l'j <br /> CONTRACTOR LIC.#(REQUIRED):i /JJ Fpfi '-Ti/tt/t CITY OF EVERETT BUSINESS LIC.#(REQUIRED):C5-?79 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CO TACT NAME: CONTACT PHONE: 411j�-._ i �1/-,a <br /> A�ro � �� , CONTACT EMAIL: 10.26 ,D /a�/r`l, ../✓�j <br /> AG EEMENT:•T hereby certify that ave rea d 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 specie 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 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 /> A -107 <br /> PERMIT# <br /> E �ps_ 2b\ <br /> O iir -�-._, Sig —"fed!” // Date (Revised 10/12/2015) <br />