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LECTRICAL PERMIT <br /> LICATION <br /> CITY OF EVERETT PERMIT 1GES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425--257-8810 FAX 425-257-8857 ] (E) everetfieps@everettwa.gov 1 www.everettwa.gov/permits <br /> tap- j� <br /> •Y�9Ud7 L-alb�6�7 pe p� <br /> - � M <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential, new construction,remodel,or addition) <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED EI DUPLEX MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> .lEL1EQ-'1"1R1 CA <br /> L-A 123f�t1 <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? YES ❑NO <br /> ASSOCIATED BUIL ING PERMIT#(if applicable): <br /> DESCRIPTION-OF WORK: <br /> _ O.W. <br /> _ .A— INFORMATION <br /> fOWNER <br /> ER NAMk-,' TENANT NAME(if Commercial): <br /> MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL• <br /> CONTRACTOR NAME: <br /> CONTRACTORADDRESS: STREET � <br /> CITY STATE o /fdc� ZIP <br /> q, <br /> CONTRACTOR PHONE: / ���� CONTRACTOR EMAIL: G <br /> CONTRACTOR LIC,#(REQUIRED); Wi WGib C CITY OF EVER=BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE-e7k <br /> CONTACT EMAIL:*44 , <br /> AGREEMENT Thereby certhlythat/have read and examined this appricalfon and know the same,.be true and correct All provisions oflaws and ordinances govemfng this <br /> type of work will be completed whether specified herein ornot 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 regulaffng construcfton or the performance of construction. That f 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 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> _ FEE <br /> PERMIT# <br /> Owner/Author gentSignatare Date (Revised 10/1212095) <br />