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ELECTRICAL PERMIT APPLICATION <br /> C;TY D--- EV E-RETT PERMIT SERVICES <br /> 3203 CEDAR STREET, EVERETT, WA 99201 <br /> (P) 425-287-8015 1 FA X 2 3z ,D ev <br /> �:_�-2:�, -AaSa � � ?+/?�� [��3Si�.,eeC1fnV7.g0+( I vilAw.ever3ttm3 go`J(J3rRi:;._s <br /> PROJECT SITE INFORMATION <br /> 1_PROJE-cr ADCREas,: G''c. <br /> 3;., ..D,V,, . A r>, .i y.:1 <br /> 5 <br /> R <br /> ELEGTR1CAL APDL 1DAt!ON'IHF:ORMATION <br /> CONTRACT PRICE OF WORK: 3 7 = ro <br /> NUMBER OF DEVICES (if low a,pl'.agr1: <br /> FIRE ALARM? 0 YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(i:'applicable): <br /> 1 VA <br /> CONT t'I I FOR 310 ' <br /> "Anti'ER NAME: TNIML <br /> DAN.SR MAILUN3 LtDD 3: yr ----. C ,. <br /> 1 <br /> altw tr. <br /> ?9FNER PHD4E: i'��I ■'�", ;XV—, �`Ae {}4, <br /> Ob€4.R=MAIL: t <br /> L D:YTRACTD AD) .....E3',..5. ti !_' = J , r <br /> _;.' �., Re 93 2v 1 <br /> {; sr, A-, zl� <br /> CONTRACTOR PHONE: `i ! J CONTRACTOR EMAIL: • <br /> i..C��T�?:��'s�.�� � CY.�-I�LGJ: " -�-r ..E�l ��#� � � r a y� <br /> 5 `nh�W - 7-dam - --_._. �y-- <br /> CITY OF EVERETT BUSINE5S LIC.#Ii�EOUIREQ,: I vo <br /> 'RIMARY CONTACT: ❑OWNER r CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: 5.£t0 T-o <br /> 61C40le CONTACT EMAIL: debt' him •c0� <br /> AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type <br /> of work will be completed whether speed herein cr not. The granting of a permit does not presume to give authority to violate or cancel me provisions of any other stale or <br /> local law regulating construction or the performance of construction. That 1 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 296.2c0 WAC. <br /> City of Everett Cfficiat Use Cray <br /> �--_. ��. �,,^�y t�A , 1r'/� J) }/�'/ PERMIT� <br /> C-,vrathait�th rued A ori S: ....__._. L-� 1 V 611)—'102 �s gna ,reE 1 <br /> Eats <br /> (PPwrsed gi<.3,2C:t'; <br />