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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> ' PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2.1 IL-{ l P( <br /> BUILDING AREA(if residential, new construction, remodel,or addition)_„ SF <br /> BUILDING TYPE:,SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2.-50 . <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable}: <br /> DESCRIPTION OF WORK: I Y15 C4.t,n, `{ ' 5 O,. .punkf <br /> CONTACT INFORMATION <br /> OWNER NAME: 'Sharp n - ' TENANT NAME(If Commercial <br /> OWNER MAILING ADDRESS: STREET j L4 6 7` L. LAD <br /> ' ^µy i/{�yry /� <br /> 0 <br /> CITY � 4)L...V fop STATE VADi J ZIP 4 S7 Lel/3 <br /> OWNER PHONE: • t`l s OWNER EMAIL: <br /> CONTRACTOR NAME: f t aCtal <br /> CONTRACTOR ADDRESS: STREET l 5 WOC ktX <br /> CIN k.! STATE ,"' ZIP n 201 <br /> CONTRACTOR PHONE: IS s,^G •'*, , 6 CONTRACTOR EMAIL: f ' /at " .161 t e , co ry <br /> CONTRACTOR LIC,#(REoUtRED):CYYth .0 f'y}itAl ( CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 1(OC] <br /> PRIMARY CONTACT: 0 OWNER ►S CONTRACTOR 0 OTHER(Please Specify) » <br /> CONTACT NAME: CONTACT PHONE: Ci D(`' .X.) <br /> Woie{. CONTACT EMAIL: 600t { C} ! `'e.a •corn <br /> AGREEMENT:I hereby certify that I have read and examined(his 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 /> Feb ) I2_ 2:717 E I112' I l <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />