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I <br /> grr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 ID ORIGINAL <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov j www.everettwa.gov/permits <br /> ili = R ZT V WE, **—***w ..= .a _Z I 71 <br /> r <br /> PROJECT ADDRESS:8 0 till du <br /> 3 f ci(k) <br /> BUILDING AREA(if residential,new construction,remodel,or addition) K eeiliha I SF <br /> BUILDING TYPE: kg-FR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> l—) <br /> � l#4t'Mr 't n`. �dr� �4 i" y, � _ r {, �, rr,_ <br /> ': i `T ICAL A0 itATiQN a#N r,OR ATIQN" G" �'�a4,�j � r its �6, itis ; <br /> 6l ili il( i ire . ti G <br /> CONTRACT PRICE OF W• K: $ l ' Q <br /> NUMBER OF DEVICES (f low voltage): <br /> FIRE ALARM? 0 Y • NO <br /> ASSOCIATED BUILDING PERMIT#(if a Iicable): y/,,,, )] ,,( ,! <br /> DESCRIPTION OF WORK: WA <br /> i kn ej ICONS P72r -i-he ,(i- z/ C?T- � !(JVj f.Ps <br /> co(' 2-- Cir- (` �f'ic p� ¶ In*Algflon of 16(,ve4eir <br /> b it .A 4, C , ,0--�. ,,..may ; w '444 CONT CTIINFORMATIOI ' ,A ,if'' > m <br /> OWNER NAME:LauWA aro CMQa/ P Dir*) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET tjto ' -t. rH6 <br /> CITY �Ciegt-f STATE' L ZIP /8Z7G/ <br /> OWNER PHONE:1Z39— qI z4 OWNER EMAIL: Lcl(kad irtu yarnod , l dfl1 <br /> CONTRACTOR NAME:f He VOW <br /> CONTRACTOR ADDRESS: sTREET111c„ 22/)Pi VL 36,0 J ' f <br /> CITY i , LeV,I(ile STATE Cit- ZIP 113c '[? f �jCONTRACTOR PHONE:'J" 7 I CONTRACTOR EMAIL: 14Q , i (,f �� /j <br /> CONTRACTOR LIC #(REQUIRED) `-•uFFw 4 M_ CITY OF EVERETT BUSINESS LIC.#(REQUIRED)O5Z7'" <br /> PRIMARY CONTACT: 0 OWNER 6ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT <br /> �NAME: CONTACT PHONE:' :_ - —7,_... f <br /> \(U 11f/l� ft2( ç CONTACT EMAIL: oQ / _( <br /> AGREEMENT.•Thereby certifythatl e read d examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this c <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 /> tki w ,....---_ <br /> PERMIT# <br /> tl/3 //g E LgL C 02_90, er uth• z-• • igna u � Date (Revised 10/12/2015) <br />