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grr IlitECTRICAL PERMIT APitI AT O
<br /> C ION
<br /> CITY OF EVERETT PERMIT SERVICESn�
<br /> 3200 CEDAR STREET, EVERETT,WA 98201 0 ORIGINAL
<br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> L a� i -100.-40x 4 i-`K r.�u - v "�« aP`nni,�ls4� .i ti15,... ,.rmR '7`F` i�� + 's«.'` —,.=s",��`�' � rw'4'Ui v�. . [{�
<br /> PROJECT ADDRESS:{Wi '15r pg. E �Jnd'
<br /> BUILDING AREA(i Ide ,new construction, remodel,or addition)rA41 SF
<br /> BUILDING TYPEA'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING:
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<br /> � �li ., 4` '• ,@n�§ _ � I r��'ll ;17111914112r
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<br /> dlQiir� d4�ili�b���ck "'rda�V�aB (flG ��iit��.,a;>.z `m elm .., "i �a7tPTi lli itNF �rf' .��u�u rv7Rtaw.. mc�dt �.ne. �.�IR„t�`uwa.sxi 6�41i ->flril �� N:. TMIG�y. e �s^-err.w:,�`ad,iFk`ti''r �iu i' �,�IyI@i� C�:_ f9V���. .x�
<br /> CONTRACT PRICE OF WORK:$ i.
<br /> NUMBER OF DEVICES (if low voltage):
<br /> FIRE ALARM? ❑YES ❑ NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: i\ clic Vire' 4?V(?O(,l aid /c iatv
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<br /> re ,40A a ,l, -,,,„1.4&,,,-1.1_`.?' =„i.) -�€-` �fl, 41, �M .,?�iik t',RH, _ryVa ,Why 1 rte.~ kti i -..._706,4111l' "i �,�) ,
<br /> ,. s. s'� iw _
<br /> OWNER NAME: Gn K5 YiCe TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET i(J(j9 pry 0E &'fi1-
<br /> //////111111������rrrrrr 7�i
<br /> CITY EV,r�t� STATE 14 ZIP ;
<br /> OWNER PHONE:✓ '� Z C[�6 OWNER EMAIL: --' CCCCCC//////
<br /> CONTRACTOR NAME: 13'1 ve Eoe �f/� ,/ , //
<br /> CONTRACTOR ADDRESS: STREET „4 9 / (j'(SW 431
<br /> CITY HD `—V �/ ff” STATE ZIP 04
<br /> CONTRACTOR PHONE: q,z — l I - 11,3 ( CONTRACTOR EMAIL: info®p 0 d e
<br /> CONTRACTOR LIC.#(REQUIRED): l_U�"FFit/km CITY OF EVERETT BUSINESS LIC.#(REQUIRED)067 7Q0
<br /> PRIMARY CONTACT: 0 OWNER .CONTRACTOR ❑OTHER(Please Specify)
<br /> CON AC._aT NAME:E (n CONTACT PHONE: 125 "7"]1—"?/Ong Y ! ilarCONTACT EMAIL: 1/, J�' Q (Y'"'l'L1 1671/i'�P/fAGREEMENT:T hereby certify td ained this application and know the same to be true and correct. All provisions of laws and ordinances governing t is
<br /> type of work will be completed wed 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 /> 4 .--NOS'
<br /> PERMIT#tD1
<br /> ' 11
<br /> Owne u :,airg`I'-nt Si4•-ture Date (Revised 10/12/2015)
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