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4477- •ECTRICAL PERMIT APF 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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:/ '/g 12,/sr S7- SE f/��� -i Cda� 5 $' Z.08 <br /> BUILDING AREA(if residential,new construction remode)or addition) / 7 2 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: RI COMMERCIAL <br /> USE OF BUILDING: /1.4 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ b©C_7 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES 121 NO � / <br /> ASSOCIATED BUILDING PERMIT#(if applicable): (7 Ili <br /> i 0 J 0 (p <br /> DESCRIPTION OF WORK: A if ieu I/&LT,4GE t. S <br /> ? / 'C A? t c3 ( 3 G c-r/`t- TIS ? -' ®. J 6 - S'c.J /. C Ate <br /> CONTACT INFORMATION <br /> OWNER NAME: 77/E T'/L a2 77- C TENANT NAME(If Commercial):--5./4k.4 . 1-4(1E <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 6 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): F-,A/72 ity - �,� CITY OF EVERETT BUSINESS LIC.#(REQUIRED)O j,J ) <br /> PRIMARY CONTACT: grOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2_fr.:pa.?—0 $as <br /> 1 a <br /> -f-#A- 2 ) /214 s4-k7 CONTACT EMAIL: %?/1.it/1 y((/? L/4,/C. ,(1-9 <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 governing 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 /> PERMIT# <br /> `p-/ . 0 2 E 1 -7 / 6 - Lc-3 <br /> 0 ner uthorized Agent Sig'ature Date (Revised 9/23/2016) <br />