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• /'2gFa50.2.030 X973 <br /> iLIPP" ELECTRICAL PERMIT APPUCAI ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 f FAX 425-2578857 1 (E) everetteps@everettwagov I www.everettwa.gov/permits <br /> • " ••:• ;..?PROJECT Sbi <br /> ....'moi:- ... ,.. ....�.,...... ,. .. .. ,. -_.. ., . ,. ,. .... .- .r�ia.a�.r,- T+.: n .w.:::•-•.:.:,,-�+�.+ -.,. ,_. - .. ....._..._. + � _ _. ... <br /> PROJECT ADDRESS: D -53 j // i,, (59d1-/11/ L-. <br /> BUILDING AREA(if residential,new construction, remoI or addition) SF <br /> BUILDING TYPE: D SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX b MULTI-FAMILY-#OF UNITS: ig COMMERCIAL <br /> USE OF BUILDING: 0e kt EVA TT- <br /> .... .. ._.v _..., -,19401113.104:140",01011...,. ..... —. .ti..n..r a..... ....4„v._.. _....:�L�i'.t�.d,"._..o+:f[•,i...._..r> :I:ti�::'tr;L.. <br /> CONTRACT PRICE OF WORK:$ 5? ® 7 <br /> NUMBER OF DEVICES(if(ow voltage): <br /> FIRE ALARM? D YES 14 NO <br /> ASSOCIATED BUILi7ING PERMIT#(if aIplicable): <br /> DESCRIPTION OF WORK: / /0' / / /7/J/j ll.;t ,9j114 1 f <br /> / ? <br /> • CONTACT INIFORMATION. <br /> OWNER NAME: TENANT NAME(if Commercial): / .)6 <br /> OWNER MAILING ADDRESS: STREET Po Box 3707 <br /> cnY 501-T7-Le" STATE V/11- ZIR81217 2207 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ge.,0664ttL laiJ.5fl ue.-rok) <br /> CONTRACTOR ADDRESS: STREET PO {3t2X 44' �� //a Q /�LyG/ <br /> CnY mJ/��ILJ- C� STATEN V ZIP 9f32� L <br /> CONTRACTOR PHONE:425-2' 4 6944 CONTRACTOR EMAIL: k/ye f. H4 ')/n 4'k/, w'r, 60/Y) <br /> CONTRACTOR LIC,#(REQUIRED): �N��'CC o`7 D Z ___CITY or EVERETT SUSiNESS LIC. (REQUIRED):Q4DS?J ^ <br /> ...._..,rte. ..._. M..r... . ,.,.. -...,.,..-.«.. <br /> PRIMARY CONTACT: 0 OWNER Pi CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: ',I CONTACT PHONE: 206-73�1O�- 5j'�o • <br /> . DeN N p r 5 c O 1/v CONTACT EMAIL: DEMI IS.1. DL a kik-W l T. (D/Y <br /> AGREEMENT:T hereby certify that t have read and examined this application and know the same to be true and correct. All provisions ofiaws 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 I <br /> comply with the State Contractors Law 98.27 RCW and 286.20d WAC. <br /> Cily of Everett Official Use Only <br /> FEE <br /> ib <br /> • 99 9 - <br /> PERMIT# <br /> +/(_. 1 , E 1& ( - X23 <br /> Owned Agen Signature Date (Revised 10/12/2015) <br />