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4177 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 1aRIINAL <br /> (P) 425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov � www.e gov perm's <br /> i4�� '�`��� �9'I1 ��� �'til'i�� 'iii �� �as �' nn um m^+ i a � � i i i itri � �iis <br /> u a s. s SIE PR JEC IT1 INF ORRMAT O �� �t �a 4r1, I, .F r <br /> PROJECT ADDRESS: 711 tifiL 9i-.qct <br /> BUILDING AREA(if residential,new construction,remodel,or addition) r6icp,`fi4-iSF <br /> BUILDING TYPE SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> t �2 1 'P%� i tra � 4 t +: <br /> ELECTRICAL APPLICATION INFORMATION <br /> /fin .":.. ..- - .. .'✓,t eain .�.m3�� .4�tv..r . 34mre � .R i.. :.fin ) vl s8+",. r t� �. <br /> CONTRACT PRICE OF WORK:Sea <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): n. <br /> DESCRIPTION OF WORK: 1Q V� Ut L��G <br /> 1-VI (//t9&? an �� � <br /> (PigOci 46q0cidritv S C.o1n �ir cc�� •I � l / <br /> k- <br /> 14;T- `J <br /> ONTACT INFORMATION <br /> OWNER NAME:Th/6 tlarris TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET/ �J[)7 �� 41-‘ <br /> �� <br /> CITY ` v STATE ZIP Lg(/ <br /> OWNER PHONE:q25---314- 5Z OWNER EMAIL: <br /> CONTRACTOR NAME:13I(, 1 a <br /> CONTRACTOR ADDRESS: STREET 1111 Co /10147T,�/k /,q,) #1 ��/•� <br /> CITY!i(/ N 7 J l iL / �I�K. STATE ZIP q 'V <br /> CONTRACTOR PHONE:41Ti I CONTRACTOR EMAIL:;Vika I�j� , (2m <br /> CONTRACTOR LIC.#(REQUIRED): F 8J CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(%, <br /> PRIMARY CONTACT: ❑OWNER A-CONTRACTOR 0 OTHER(Please Specify) <br /> CO TACT NAME: CONTACT PHONE:'1.0.-77/—) /i <br /> 1 Y A 1 i-If2geaeAGREEMENT.'Thereby certify that 1hread a xamined 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 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 /> PERMIT# <br /> Mg/16 E k. (gOS -Oa <br /> a <br /> Own • ent Si.I,. re Date (Revised 10/12/2015) <br /> / R <br />