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-925-27d F,0/4J 3075 <br /> 1144 ELECTRICAL PE BT 1\PPLUCATlON • <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] www.everettwa.gov/permits <br /> :i ',{:. ..:\:.. ,...a.....:,,: .. .. .. ..... ... . .. .. ..� rr•R.:J.f,. o.r. v..,�w ,'.V .:.._),71.x`..... :...�.../.� //.-- .........,......._..._....., :..... i..!__ J:.._.,•h.i..-�, <br /> PROJECT ADDRESS: 0)- 5e/ , r ' ""F t d t •ZO • <br /> BUILDING AREA(if residential,new construction,remade or addition) SF , <br /> BUILDING TYPE: D SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX L MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: QElxG EVEEET 7" • <br /> - '•TEL GT G,� ..,o. ''�a�: <br /> 1� 1.:•;APiPIL-it 7' I �I�ORMATI0A1"�� <br /> ::� -. .. . .. ._ R _ .A ■■ ■may■ .. `ti. <br /> :11 -... _ . .. :_ ,":•at �_ :rrsT:�. ':.� .-a i....:=:_r...!S.y"z-7-�-r1•c..:4,� ,12nv i.�..,:. .. ..u•...::. __._:.•�t4i.:r: .e�`.a.,._..,..,.,,:. . ...�,: <br /> CONTRACT PRICE OF WORK:$ 000 • <br /> NUMBER OF DEVICES(if low voltage):• <br /> FIRE ALARM? 0 YES Xi NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 601 q Ik)Z. J r4 �� / ,� <br /> //zt) <br /> ;; • CONTACT IiNFORMATIION • <br /> OWNER NAME: TENANT NAME(If Commercial): frjtJG <br /> OWNER MAILING ADDRESS: STREET l�d &)/( 5707 <br /> / y/� <br /> CrrY 'TL/ ,' STATE ✓�/4 .8512 y-2207 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 2e/Ogi <br /> CONTRACTOR ADDRESS: STREET A $OX 4ii <br /> crrY1 mag/L 2c STATE/Ja <br /> ,,,q z 4 <br /> CONTRACTOR PHONE:426-214494yJ CONTRACTOR EMAIL: k4 Q1 . H40/Y?E12 / W//r', Ct9/Y) <br /> CONTRACTOR LIC.-#(REQUIRED)^ aE.... � 't. z CITY OF EVERETTBUSINESSLIC.#(REQUIRED):0 )0V <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR ❑OTHER(Please Specify) / <br /> CONTACT NAME: ,�/ CONTACT PHONE: 204,-73 6--(p 51-1- <br /> �� J 1 ci 6�.o to CONTACT EMAIL: DEAN i S.�.gOw 15.i I T. t.D/Y) <br /> AGREEMENT Thereby certify that I have read and examined this application and know the same to be true and correct All provisions of!am and ordinances governing this <br /> type of work wilt 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 perfonnance at construction. That 1 am authorized by the owner of this property to perform the work for which application is made end I <br /> comply with the State Contractors Law 18.27 RCWand 296_200 WAC. <br /> City of Everett Official Use Only <br /> FEE 'Pc <br /> /40 <br /> PERMIT# <br /> E VSOL( <br /> owner/Au orized Agen Signature Date (Revised 10/12/2015) <br />