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LECTRICAL PERMIT VLICATION <br /> CITY OF EVERETT PERMIT VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1 (E) evereftepsAeverettwagov j www.everettwagov1permits <br /> -J <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential, new construction,remodel, or addition) SF <br /> IBUILDING TYPE: U SFR-DETACHED 11 SFR ATTACHED El DUPLEX (XULTI-FAMILY-#OF UNITS: El COMMERCIAL <br /> USE OF BUILDING: <br /> ACT PRICE CONTRACT OF WORK:$ r <br /> TR <br /> OU" NFO <br /> Go <br /> FNUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? ;<YES El NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK* <br /> 7 <br /> 'cot INF.ORMATIO <br /> TENANT NAME(if Commercial): <br /> .()W <br /> NEP. <br /> [OWNER MAILING ADDRESS: STREET <br /> MY STATE ZIP <br /> OWNER PHONE, OWNER EMAIL; <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET 14 CAAXO'�17 <br /> CITY F STATE ZIP 7ffA!? ==6 <br /> CONTRACTOR PHONE; . 1CONTRACTOR EMAIL: @4chiE- Ir <br /> CONTRACTOR LIG.ff(REQUIRED)- <br /> --- <br /> I CITY OF EVERETT BUSINESS LIG.#(REQUIRED)-. <br /> PRIMARYGONTACT: 0OWNER MCONTRACTOR 11 OTHER(Please Specify)_ <br /> CONTACT NAME: (J> CONTACT PHONE: CC <br /> ICONTACT EMAIL: <br /> AGREEMENT.•Thereby certify that/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 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 regulating construction orthe 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 18.27RCWand 296.200 WAC. City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> ovvner</,Ap:�t6�orlzed Age t lignateore Date (Revised 1011212015) <br />