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EIRCTRICAL PERMIT AP CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> vilox <br /> xz 'v t v ;ir r.-, 't;.Y�-, �...#6: sAv t'O_,N }t .`.tg$E� <br /> 3 ....bkr <br /> ' - -aigkYrna . �"dU" <br /> PROJECT ADDRESS: tlisb0t mot) PL SC <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: '$I COMMERCIAL <br /> USE OF BUILDING: 'bot-A,--6.54) O CQi <br /> , �i'+,. otiprl,4lf `t.sJ.NaA xr :;..!"�Lhn i..a:.g�..faAantisr CuSwS._,.9.�IOaA. A <br /> <.,.E...I 16i.,t..x....N,_,Fo.,OR� iATIOf <br /> N_c ..m, r ?Z, ` uR.a�.s <br /> R <br /> CONTRACT <br /> PRICE OF WORK: $ (0° <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 4f3©tUl v\.-, t 3 `Nl�k- —fl"OS * o.. a.A COYLIL.4 1 Oil_ <br /> ?(,)et: K\ <br /> S l <br /> -S`g i fir. '7'€'`a'SMP s g ss '^r` tt 3 ;h F 9 <br /> ..�n ,tr+= '.;..x t,s �,, "i,ro..f i�,a;: � �, ,, a �'Ut w a�,Wirt'S�.#�,r�F� �'-�"`.k���`�'N �a�5 <br /> w; +�u� s"� �k������, {�s'� ��� ��'>��� �� ���� �ONTACT�i1�IF�OR11ilAT10N . � <br /> OWNER NAME: TENANT NAME(If Commercial): 40- Q"b.t> la lets <br /> OWNER MAILING ADDRESS: STREET ►fib\ IbO FL- SC <br /> CITY <br /> M—k STATE 1( ZIP J p2,O <br /> OWNER PHONE: +2S`s$1'•` atsa. OWNER EMAIL: <br /> .__..,.,„, „ <br /> CONTRACTOR NAME: '€ate-7TY1 c [ Y i --"i 36(11-41 OY1 <br /> CONTRACTOR ADDRESS: STREET Po <br /> CITY Ma--e—I4 414 STATE YvQ I _ , CZIIPP 10 <br /> CONTRACTOR PHONE: 3(c2O ' g'1 CONTRACTOR EMAIL: •I r\-{"b Y 1 = o.oii— <br /> Pt- �y CITY OF EVERETT BUSINESS EQUIRED) <br /> CONTRACTOR LIC.#(REQUIRED): �1�Uc��� <br /> PRIMARY CONTACT: 0 OWNER gCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: J(.Ql) 1660 <br /> AGLAN.-& CONTACT EMAIL: `i h i — °" <br /> 1 tVIA.,, CI-c�SWI' <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 overning 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 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 /> f^ PERMIT# <br /> • <br /> (1) I (bit IR E 1(6(10--PSO <br /> g Date (Revised 9/23/2016) <br /> Owner/Aut�orizea'"Agent Signature <br />