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<br /> )010WL'T ELECTIIICAL PEMiffT ,t,P rs LIC,/,‘,111 sio r.N,'
<br /> '4trogj - CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 i FAX 426-267-8857 1 (E)everettepageveretlwagav j www,everettwa.gavfpertnita
<br /> ::--::!. •, . • --, - ':.-:-- ,.: ,-. --- ,-., ...-. 4dottfif4llifr ::;.41114.*?..i ,. ,-:. ,-,------ :• ' :,-- .1,1..'- = L'''-'.- ::::, ,
<br /> PROJECT ADDRESS: 4 zrzi --tollo tz- 5-v,)
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<br /> suLDING AREA(if residential,new construction,remodel,or addition) 1:,,,t/4 SF
<br /> 'BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: In COMMERCIAL
<br /> USE OF OUILDING: — I, - 4 5 oocom oo...
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<br /> CONTRACT PRICE OF WORK:$
<br /> NUMBER OF DEVICES(if low voltage):'
<br /> FIRE ALARM? 0 YES X NO
<br /> ASSOCIATED BUILDING PERMIT#(d applicable): Ajlii.
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<br /> • DESCRIPTION OF WORK: 4,4, ,.1..-irk,t.A.,.. Ascr.0 ,etz,441.444L, se-a.Noie,...e cwt.- -mtktort-coo
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<br /> OWNER NAME: d try two ob o- * TENANT NAME Of Commercial): Nli itifo. 1
<br /> OWNER IVIAII-ING ADDRESS: slam- 32.0iso e...6p4sa. -sc.-- 1
<br /> cow ev STATE iviA zip glIS Zibi
<br /> OWNEFt PHONE: q24- ZS, seti !OWNER ENIAIL:
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<br /> CONTRACTOR NAME: L.40eobi-
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<br /> CONTRACTOR ADDRESS: smtei 8 i 7 A .... Ce,i otkor- 4 PN
<br /> CITY fooaor V cdf 4 s STATE 6,61$4 EP m".•°:, C73
<br /> coNrRAGToRpnoNe 34,D. 14 co-peo CONTRACTOR ENTAIL:
<br /> CONTRACTOR LIC.#(REQUIRED): CteZ71)//41,VX OW 1 OF EVERETT BUSINESS L1C,IRREQUIRED): 0 3
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<br /> PRIMARY CONTACT: 0 OWNER gCONTRACTOR 0 OTHER(Please SpecilY)
<br /> CONTACT NAME: CONTACT PHONE: "Loom lig ... -41,3 7 b
<br /> •6.040.30 *RDILLA CONTACT EMAIL:At o' 00, - C.—kit 47;".• $ego"4 i
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<br /> AGREEMENT:T hereby certify that I have read end examined flits appffeettaft and knew ihe somata b a tree end cogent All provisions anew and ordinance*governbg this
<br /> typeetwoM wi I i tra completed Whether apeclffettherein or not The granting ore pannff does not presume to give author I t yin violate or cancel the provisions otany oilier stale or
<br /> local lawregulallng construction orthe performance of constructIon. That lam authorize d hythe ownerofihis property to perform the woik for which application Isparta-and]
<br /> ceRIPkwiTh the Slate Confractom Law 18,27 ROW and 296.200 WAQ
<br /> . C16 e a f Everett Offfcial Use Only
<br /> FEE 1
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<br /> 1 PERMIT#
<br /> ) / 22-7/r E \1St( - , (0 j k
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<br /> OwneriAuthoiked Agent Signa. a Date (Revised 10d2/2016)
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