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ELECTRICAL PERMIT AP LIICCATII®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> rETT <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 J (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> PROJECT ADDRESS: tiZ4,a..3 3 1 OS S+ J <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF <br /> ;BUILDING TYPE:, SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: j V. r <br /> i <br /> �1 �51,"9 ,.,. ,. r. '�®N Allo -, .,l�ir'9 )Ni <br /> CONTRACT PRICE OF WORK:$ -L S'�_.._... <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES Pko <br /> ASSOCIATED BUILDING PERMIT#(if applicable): - <br /> DESCRIPT ON OF WORK: - �( Q� , S1 51#4.74.‹. .6 �Gt�SL <br /> • <br /> - - = - • CONTACT iil4F®itiiAT ®ri. <br /> OWNER NAME: RrS Cylph, TENANT NNAM E(If <br /> Commercial)): <br /> OWNER MAILING ADDRESS: s7REEr to-8u- 4JVW l <br /> c CITY STATE <br /> ZIP ‘IgQ16 <br /> / <br /> OWNER PHONE:4449Z 3b ' SS 1S OWNER EMAIL: , .. . <br /> . <br /> CONTRACTOR NAME: LR)ta" (-5 <br /> CONTRACTOR ADDRESS: STREET Al. N'C4) tm,tl(k„,,A cid, <br /> cm( Cayy«•I,10. STATE ZIP lU I\CJ 24 <br /> CONTRACTOR PHONE:—.5 tap 3H Z /4.7 L CONTRACTOR EMAIL: Sy,�j ��! ..i4eXtiJork <br /> CONTRACTOR LIC,#(REQUIRED): S La 10. 4.6X Q S I CITY OF EVERETT BUSINESS LIC.#(REQUIRED):5 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 3,40..3g 7 /451_ <br /> t :Q CONTACT EMAIL:�� J ''� Li�lil <br /> AGREEMENT.T hereby certify that 1 h ead and examined this application and know the same to be true and correctt 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! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> OCI <br /> 4 'ma .----- <br /> PERMIT og nocc, <br /> Owner/Auth• zed Agen l'rte' Da - (Revised 10/12/2015) <br />