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, a ELECTRICAL PERMIT APPLICATION <br /> N <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:j www everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 9/6. PAc(At Alit, <br /> BUILDING AREA(if residential,new:construction,remodel,or addition) $F <br /> BUILDING TYPE: 0 SFR-DETACHED D SFR-ATTACHED 0 DUPLEX D MULTI-FAMILY-#OF UNITS. COMMERCIAL <br /> USE OF BUILDING: Plec,?9,134, Iiik <br /> f l,r . <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE.OF WORK $ 6'60{ •— C -e,, Aktivil,m,braa I ,L /1 T I(ILL <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT# f'f applicable):,. <br /> DESCRIPTION OF WORK: l' 7 /14%).4. ked d <br /> 77 'Y8=a <br /> 617 r) kw 2-r?/y.3t6 3 664ve. , _ ,'2 24 <br /> Kit' r 2-414 2O <br /> CONTACT INFORMATION <br /> OWNER NAME: / I,LR -e ' (14TENANT NAME(If Commercial): Pe r/1/ <br /> OWNER MAILING ADDRESSR.r.Z.: STREET '43 477 <br /> CITY c.? rpt STATE 4.001 -_ZIP Z(0Y'u <br /> OWNER PHONE: l .S _ 3/6— SOO' + OWNER EMAIL: <br /> CONTRACTOR NAME: <7.4,44#1,14r1.3 /.4 <br /> CONTRACTOR ADDRESS: STREET 8W S( 1 &c, <br /> CRT Pewe Z,P / ( O.3 <br /> CONTRACTOR PHONE: : CONTRACTOR EMAIL: pleJr 145..56Ciotovh ut Cc n <br /> CONTRACTOR LIC,#(REQUIRED):rI10101.41 a fitricoY CITY OF.EVERETT BUSINESS LIC,#(REQUIREDI:06117211 <br /> PRIMARY CONTACT; 0 OWNER ,.CONTRACTOR D:OTHER;(Ptease: pecify) <br /> CONTACT NAME: CONTACT PHONE: f' 21,—.7:3).1 <br /> — <br /> DAP/ ✓ "%soil" CONTACT EMAIL "• L .SW"1'I', n�n^l <br /> C xJ;3, CO <br /> AGREEMENT:T hereby certify that l have read and examined this application andltnow the same-ta be true and correct: All pmvisions of laws 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 /> tool law regulating construction or the performance of-construction, That!am authorized ey the owner of this property to perform We work for which application is,made and l <br /> comply with the State Contractors Law'18 2T RCW and 298.200 WAC <br /> City of Everett•"Ofticiel Use Only <br /> FEE <br /> 4 \i 'D.„ 1) <br /> PERMIT# <br /> 4.../.1 j.,.........., <br /> /3—//6 <br /> E \Up t (\)�� <br /> 4wnerlAuthor ze nt Stgnature. Date;; (Revised 10/12120 5) <br />