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ELECTRICAL PERMIT AP S ATI N <br /> CITY OF EVEREI I PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsgeveret1wa.gov I www.everettwagovlpermits <br /> . • (E)eveSire i41FCyi2MATION ; <br /> 'PROJECT ADDRESS: i s--2,--=., r <br /> BUILDING AREA(if residential,new construction,remodel,or addition) ..R . 1 SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX. El MULTI-FAMILY-#OF UNITS: El COMMERCIAL <br /> USE OF BUILDING: .. <br /> -._ E Ed`1'Ri A APPOCA'i'ION iMF RMliti®$:- . <br /> CONTRACT PRICE OF WORK:$ ..,• <br /> NUMBER OF DEVICES(if low voltage): "". <br /> FIRE ALARM? El YES O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: #+t,k&^d- .. AJE,c- 4.10x3 .. -lb oe.,4 I .E►.ry <br /> 04,0 <br /> pt P11.341_ <br /> a F.. <br /> V®lZ rAdit Il`ii OIRNIATION <br /> OWNER NAME: t)4=Mi4A AkiN PITT r) l - TENANT NAME(If Commercial;• , <br /> OWNER MAILING ADDRESS: STREET, l'57,L-�c <br /> " ► 3'� ' . <br /> ,y En(. EV STAIE - _...,1 g7p ttt `': <br /> 6"" <br /> OWNER PHONE: 4f 7" 3'÷g "° ' * OWNER.EMAIL: '— <br /> CONTRACTOR NAME: . " ' ?.t "" <br /> CONTRACTOR ADDRESS: smr 1:?d,Btag. i <br /> • CrrY ap7 `p 1 <br /> STATE [.�7- ` <br /> CONTRACTOR PHONE: x"-4 - +i g CONTRACTOR EMAIL:-6. "`tisS pea p.,e-i....0V-4-5t42-1'z. 4E ' <br /> coNTRACTOR LIC.*(REQUIRED): rts,'Pc�G':" 7- Ck'i'Y OF EVERETT EUSINESS LIC,M LIUIRED) " <br /> PRIMARY CONTACT: "j OWNER. 0 CONTRACTOR Cl OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: r- 3 sti 'm '`'" <br /> t-IP, 14r.'") -7---- .CONTACT EMAIL: ..... <br /> vimns of laws and ordinances governing this <br /> AGREEMENT:7-heteby:;err5(ythafihave read and examined this application and know the same to be true rrwrrect All pro `s <br /> typeafwork wit be completed whether apeaMed.herein or not The granting ofa permif does not presume togive autho ityto violate or cancel the provisions of any other state or <br /> local labs regulating constn+offon arthe performance of construction_ That/aniauthorized by the owner o f this properly to perform thew*farwhfck apP'cation is made and l <br /> comply with the State Contractors Law 18.27 ROW and296 20014&4C. <br /> City of Everett Official Use-Only <br /> FEE _^ <br /> 4 fid® <br /> PERMIT* <br /> iii • E (?),0--1-27.,______ <br /> Owner/Authorized ant Signature Date (Revised 10/1212015) <br />