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LLCTRICAL PERMIT APPLICATPRI <br /> °111/14%0 ---A <br /> CITY OF EVERETT PERMIT0/4/SERVICES V/4,/'�,� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 V 4L <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> , S� r "5 ,i tW al. ,, x" 1 ++'+ayru<< hIT is"" f r !� J �I w <br /> .11', 11' <br /> i i ,1 "" SIU , i!�'iI" p , �Nt.----'11R- <br /> -- n ' 1'z .. j I'z'" 4'�F9 Pr7811$9J— � <br /> x o �6,a == �m ':�. .����'Pk€-�� � "� 91E =�i�r� ,nsr.i� °- —1r �� ��: '� ��°d�.��(��_. tiler b„Scw �.y �r �a r <br /> PROJECT ADDRESS: ("2/6Z 10 cyr--- Ct. <br /> BUILDING AREA(if residential,new construction,remodel,or addition) '2,1 I K (5 SF <br /> BUILDING'TYPE:? <br /> ISFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> { reih : Cc� AW' 101 t ! 04/ iOry _ I14 � i <br /> CONTRACT PRICE OF WORK:$ Le <br /> '.. <br /> 6-0 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: COC 01 f/ OlAA"\--- V A1C— ( v\S'-( ( <br /> i Ed� �. , E r ��'ij, a` " i = � q .ns�... n n . ., ,Y-t=�g:,- !� i! �_ a a rr=�'4� K -r"s �a r-s;bii �_-,: <br /> iIi 71ir '�i �r iatih. r. �F �. r "�� i,. h%-, !► rw,�r „i'ip r G.I li >�� "t.�, it> lo-i w iigii - i�,i'r#... <br /> OIIGdy1' ,:.:_,qui Iru t.�rrlr :nai",.. {6i�ximV li.�-`••�idrlil .�, r I��i �i A�i^'T...I FQ� T 0,75 I ,n, �a 1 ? i� t� �' <br /> > r�� a;��Uaa i >w �}(��• ! � ; iPr�shl� � 7� �U i `�'��bl���i! .14i �aial�",'3� �ta� 'yd .'�"�lii it W ial,. <br /> OWNER NAME: L C-(/v CQ l '"(--(2-- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1 \ <.e 2,2-L.61-1-- Sfi .& <br /> 9k 3 <br /> CITY �� �'1 STATE � ZIP t <br /> OWNER PHONE: `r"Tr/ <br /> "i 1- -1 `?j ci 'OWNER EMAIL: VA. CA <br /> CONTRACTOR NAME: I 1 tie (u-VO-2-- -- � • <br /> CONTRACTOR ADDRESS: STREET ,l\ LQ� T/ �}�(� 5 .)---- t <br /> l L CITY ' `- �y STATE 1,-.1 A ` ZIP 61 �3 <br /> CONTRACTOR PHONE T •1� k'1 13 1 CONTRACTOR EMAIL: V\, l <br /> CONTRACTOR LIC.#(REQUIRED): ef 31 M 4✓1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O 2-c C <br /> PRIMARY CONTACT: 0 OWNER ,ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L–r2,c .l'—'1 1. -A ‘36-1 <br /> (----:(4.4 t /r f-� A AV CONTACT EMAIL: <br /> AGREEMENT.T hereby l certify that I have read and examined 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 /> 1 6.' °D-----" <br /> PERMIT# <br /> \K, 4O - Z' p < < E\ 02J2ZA <br /> Owner/Authori en Sim• Date (Revised 10/12/2015) <br /> 'f <br />