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LLECTRICAL PERMIT ANLICATION <br /> I�►' 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 j www.everettwa.gov/permits <br /> PROJECT 817E INFORMATION <br /> PROJECT ADDRESS: HAP(Q L M hard. <br /> BUILDING AREA(if residential, new construction, remodel,or addition) rteliDdel SF /0 <br /> BUILDING TYPE: "SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: C2�1f� L <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> (e-cit ee0Yk& l ) (l Nat-414 `,/ A k �4 <br /> .CONTACT INFORMATION <br /> OWNER NAME: <br /> ffiaryd-r) DYAD <br /> n/ ,,/TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /�/ (.Q /(V�two (//� '�//J�j <br /> Crri 1Y�.delll;,� ' STATEbat- /� ZIP -/ /�tl ' <br /> OWNER PHONE: r - I I OWNER EMAIL:ft7U Q4 O ` 4II/(f7'v I <br /> CONTRACTOR NAME: it akid J0 WA//16 <br /> CONTRACTOR ADDRESS: STREET BA, vn oi <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: )6 OWNER []CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: WAS £ (Rif/q7 <br /> :110,rJpV (iet V CONTACT EMAIL: MayUJb 73af.6-074i Jewls <br /> AGREEMENT:T 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 <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 properly to perform the work for which application is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE OD- <br /> PERMIT <br /> to <br /> # <br /> ' ) 00 ( <br /> Owned,u F.rized '• Signature Date (Revised 10/12/2015) <br />