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/o29z5- ca97a7i <br /> ELECTRICAL PERMIT A.PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 982.01 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov f www.everettwa.gov/permits <br /> �ROJI ©T.S6'I' r:p,NNFORiU1 lid <br /> PROJECT ADDRESS: 4r, <br /> [BUILDING AREA(if residential, new construction, remo:-1,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 1=1 SFR-ATTACHED 0 DUPLEX CI MULTI-FAMILY-#OF UNITS:_ 14 COMMERCIAL <br /> USE OF BUILDING: gOeTA4C, EV I 7T" <br /> ELIEdtitiCAL AMititATIANl1J11.FORMAT!<�Rl ,. <br /> CONTRACT PRICE OF WORK:$ 37900 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES /4 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: efrZsdate07 �f- / // /• j / <br /> 41-//117j ier& f:Ift-tala-de/) Z5-4, <br /> : . ._ CONTACT:INFORMATION. _.. _ _r <br /> OWNER NAME: TENANT NAME(If Commercial): 13Ceitj6 <br /> OWNER MAILING ADDRESS: STREET Pa 60X 37/77 7 <br /> CITY � �L� I STATE VS/ ZIPq,512 -2207 <br /> OWNER PHONE: b 1OWNER EMAIL: <br /> CONTRACTOR NAME: g�Ei�-/)1.- Q�/V <br /> CONTRACTOR ADDRESS: STREET P��LQ7�/i�/1)XX -444 uj <br /> CHY /l l t/(j/t 7-a----62 STATE 1M ZIP elg,2 <br /> CONTRACTOR PHONE:426-214-6144 CONTRACTOR EMAIL: kibei, IMAM EA kil v-w/r,,)Coin <br /> CONTRACTOR LIC,#(REQUIRED): C3�'V�!'.Ceq g�D Z CITY OF EVERETT BUSINESS LIC,#(REQUIRED):0405 <br /> v..�-.s.we+..n.r+..v.l......a.r.�.c.,�.vr�w�wn........mr,......r..v......r...•. ..ru.r....r............,✓ro...�r.�r.......r,•...(�.w...u-.w....w...v-�.n.....�x.vim.5=�...wW.. s�c.t, tri..N...w....�...... _ <br /> PRIMARY CONTACT: D OWNER KI CONTRACTOR D OTHER(Please Specify) — <br /> CONTACT NAME: ��/ CONTACT PHONE: Zt�P-73 fJ-654-6 <br /> DN,4J 5 C& Ut/ CONTACT EMAIL: DEW/ IS.L' KDIV® OEM I T. L'O/YI <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 wine 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 properly to perform the work for which application is made and I <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE II <br /> PERMIT# <br /> /i. AI, / � -�'� E \ D - 5w <br /> Owner/Au or zed Agent Signature Date (Revised 10/i2/20-15) <br />