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"OW ELECTRICAL PERMIT 443LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ) FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION' <br /> PROJECT ADDRESS: 31//6 OCA(,. r4`,..„-i 6 fre USA 2 gz,o <br /> BUILDING AREA(if residential,new construction,remodel, or addition) 'i 4i b--4) SF ' <br /> BUILDING TYPE: Q'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX104,4... ,,,„1 <br /> 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> _ <br /> USE OF BUILDING: vt . (( U , "h 0e�,`„� N��,ti. ,-mss . <br /> ELECTRI• L APPLICATION INFORMATION <br /> CONTRACT PRICE OF WOR ” Z b t-sU <br /> NUMBER OF DEVICES(if low oltage): <br /> FIRE ALARM? 0 YES 0 N• <br /> ASSOCIATED BUILDING PERM applicable): <br /> DESCRIPTION OF WORK: N ew Ln, 1- Car - ,,,,-4-/( e;4,,-//o,...) e,“4.4 1` <br /> • <br /> CONTACT INFORMATION. <br /> OWNER NAME: 7;5' ,41 /V I (A f& 1) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S k(b pr„ `� 442. <br /> / CITY -1/'.,rt,ft STATE P 6 ZIP A9 Z 0/ <br /> OWNER PHONE: Zeit -O.4ZZ- OWNER EMAIL: Jo�r1„ I�/���¢ df 5r4ra G,by+:fa,Lf aCokl <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC,#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED} <br /> PRIMARY CONTACT: VLOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: zoc-4t 63 (5K-0-2-- <br /> ' ---,;114,, <br /> j KF --O 11M I I✓ —WiCONTACT EMAIL: -0-7t 10 . pi(Ne;It S(-E ® &le/7 (. <br /> AGREEMENT:T hereby certifythat I have read and examined this application and know the same to be true and correct. All provisions 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 /> local law regulating construction or the performance of construction. That tam 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 /> ISD <br /> PERMIT# <br /> X A----- 2 E t oc - 04- <br /> c/Authorized Agent Signature ate (Revised 10/12/2015) <br />