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ELECTRICAL PERMIT APPLICATION
<br /> ......e114 �� CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425--257-8810 I FAX 426-257-8857 1 (E)everetteps©everettwa.gov I www_evereftwa.gov/permits
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<br /> PROJECT ADDRESS: -2, -,!".3 5--i,~ . .--1- LA-J--
<br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: " SFR-DE ACHED EI SFR ATTACHED II DUPLEX ❑MULThFAMILY-#OF UNITS: ■ COMMERCIAL
<br /> USE OF BUILDING: eg,- ' AMIAlledlaimi rib
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<br /> CONTRACT PRICE OF WORK:$ 3G:t =,,— 11.
<br /> NUMBER OF DEVICES(if low voltage): ' r I i - -
<br /> FIRE ALARM? ❑YES , 'NO _
<br /> ASSOCIATED BUILDING PERMIT#(f applicable): -
<br /> DESCRIPTION OF WORK: ( -3 - e_A P--‘--+--, I-1—,' -' Z'Z, DT- `'cam-" 1OVI
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<br /> ' ` COW' INFO R IMATION -
<br /> OWNER NAME: ' -t"-Ell .., e-- g-••• - TENANT NAMEIlf Commerelal): 1.l i --
<br /> OWNER MAIUNG ADDRESS: r / -Z)'3 S ` ^
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<br /> orrYyG 41 STATE: P1 W zip,' $t,, . 3
<br /> OWNER PHONE: '9"•Z —, - S--3e,„( OWNER EMAIL: .
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<br /> CONTRACTOR NAME: ---LL-? ="P Z-ic 21 -- - - - .. -
<br /> CONTRACTOR ADDRESs; - sTaxE1. 27.1) 8 de5z r0,e553
<br /> �� ccm( 7Z -� - 6TATE /14-14�`"�^ ZIP , I!)
<br /> CONTRACTOR PHONE: S-Li"-S ---S--i_ L $ CONTRACTOR EMAIL.:c ren ..6 • - ' C-. r '
<br /> CONTRACTOR LIC. • - QUIRED): .1.0"'" g,.itS CITY OF EVERETT BUSINESS LIC. : -Bath- A:d
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<br /> ARY CONTACT: ID OWNER Ef- ONTRACTOR 111 OTHER(Please Specify) _.
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<br /> CONTACT NAM11[E: , CONTACT PHONE: 4.-, ....4.. .---4.1....„&---,- s`I .' -
<br /> CONTACT EMAIL:„L.,,,,..,(--,,,e_in J ��eh ,-,') 7
<br /> AGE MENT T hereby certify that!have read and examined this application end know the same to be true and corned. Aiprovisions of laws and ordinances governing this
<br /> type of work will he completed wtrethorspecifed herein or not The granting of a permff does not presume to give authority to violate or cancel the provisions of say other state or
<br /> focal lawr:,:Mating•.,: ...On. . - ..mai.•• • .- r r r.n_ 'at I am authorized by The owet of this piapertyto perlbrm the woj*for which application Is made shd I
<br /> •w, + • • . :Co •-ct.,f aw 1..' " Wand286.200 WAC_
<br /> City of Fvenett OtTrcJar Use Only
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<br /> - PERMIT#
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<br /> p ,, ., •, Agen ignatu i Dote (Revised:0/1212095)
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