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ELECTRICAL PERMIT APPLICATION
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<br /> 320) CEDAR STREET, EVERETT, WA 93201
<br /> (P) 125-257-3310 ' TrI-Aill75- 37-8357 1 (.-.:') ,,,,,..),- ,tt103(T':):?peo:.-atti,vvi.govi k,wiw.evarettvtia govip::.inifts
<br /> PROJECT SITE INFORMATION
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<br /> .DirECT*ADDRESS 1, OR OtQltirt S 1A-n
<br /> 3.,:..,DIN3 AREA 'r::=-; 1.,.-- i ,-.? 7 1-, 1)-41.' )1
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<br /> ELECTRICAL APpLicA:rtot4:ifiFoRmAtIoN
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<br /> CONTRACT PRICE OF WORK: S -7 ---,P
<br /> NUMBER OF DEVICES 1'3'low v',)ta3-.-i•
<br /> FIRE ALARM? DYES 0 NO
<br /> ASSOCIATED BUILDING PERMIT
<br /> _ DES CRIEDOLL OF_WORK: _
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<br /> DVINF-:R NAME:
<br /> JUIL,,,t , # ,,:' ,, TENANT NAME fir Dm;ritr:r.iat):
<br /> 3VVNER MAILING.' ADDRE33- .4:-.. ..-•-t- t gir . ir tarth S S U. .41)
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<br /> Dvvui-..-R P'11DNE: 10 IA CI°I 01 Ci IDWNZR EMAIL:
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<br /> STATE 4 A- 2,., q 20 I
<br /> :0NTRACTOR PHONE: 1-1, ---ojemq frit CONTRACTOR EMAIL: i "4//t ' # La 40 li .
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<br /> 01\ITRACTOR-1..IC:,fil7. .,:-OTRTCY'rtfM-s- VI 4 I Ctil— C-IfY OF EVERETT BUSINESS LIC,#CREQUIRED*; al ilk
<br /> PRIMARY CONTACT: 0 OWNER 'A CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:
<br /> CONTACT PHONE: 5 ;6ct 0i5s0
<br /> 1 &tiCONTACT EMAIL: (2163 I is , Vitali 'Cern
<br /> AGREEMENT:thereby certify that I have read and examined this application and know the same to be tnie and correct All provisions&laws and ordinances governing this type
<br /> 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 pelf=the„v.*fcr which application is made end I
<br /> comply with the State Contractors Law 1 .27 RCVV and 296.260 WAC.
<br /> City of Everett Cfficial Use crly
<br /> PERMIT#
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