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#111°*.z.v"-_ -‘ ELECTRICAL PERMIT AIVLICATION c.• fti CITY OF EVERETT PERMIT SERVICES `' 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits ' PROJECT SITE INFORMATION PROJECT ADDRESS: i 00 4) x-01 by F1 y cC c4ey-t vii4. co 2o BUILDING AREA(if residential,new construction,remodel,or addition) 5.00 SF ' BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING:St y1 in\R- C v W1S\ o\vot 1--\ ELECTRICAL APPLICATION INFORMATION. CONTRACT PRICE OF WORK:$ 1,500 • NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES yNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORr: --R.�W vYe-. k dc' TJhe i V1 Ks1-4,\ Ith l, I k\--, c%W w [)RM alcn . . - R.e. b� lSe-4V\ -- a t. 45`itloal;v1631 bo�etillc�. V � A CONTACT IN J rl FORMATION :. OWNER NAME: XL `'1(�VJV.�V15 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: (1-r2J C)S " KCii , .. OWNER EMAIL: CONTRACTOR NAME: (\" Nev) 4\6,0 v1 LU CONTRACTOR ADDRESS: STREET '550 1 i S� - t.) 42- - 2(XD CITY 6Nitieil STATE W ZIP ci(6203 CONTRACTOR PHONE,6725)S.1% —70Clei CONTRACTOR EMAIL: (7f Gv N\\NIZ.W A% .GOWN CONTRACTOR LIC.#(REQUIRED): MU NEN+$' !K I CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Q 175 m-,............: ...: ...,.., , .,.,,,.:,_,_.,.,..._:....,v,K.._... :.... .x- .., PRIMARY CONTACT: ❑OWNER X CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: /' CONTACT PHONE:��J 25)5It--7Ocil JOV & JO ViCONTACT EMAIL: (f6® iNa ticfc.cme+.e,aw1 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 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 local law regulating construction or the performance of construction. That lam authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 05 PERMIT# cI1‘12o1Ss E ( 0c, -,0,7 Owner/A orized Agent Signature Date (Revised 10/12/2015)