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(P) 425-257-8810 <br />• <br />�LECTRICAL PERMIT APt'LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECTADDRESS: � '`�' � '" � • <br />BUILDING AREA (if residential, new construction, remodel, or addition) ' ' �' • SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UN <br />i �, <br />USE OF BUILDING: �;� l!;'I � / � �� � " f ���� �; �r <br />� COMMERCIAL <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ �C�O . � <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES �NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: % � � � � <br />F r r � �1 2 <br />� ��I � � � ,� �� ;' 1� ;� �- , f. � � ��� _ r, j� ��', r t� �. '� ^ <br />� _, <br />� i/ I /�n F{'! ��� r. ," i! y'... <br />CONTACT INFORMATION <br />OWNER NAME: TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: s-rReer � � t; ` <br />se6o d��s�, ,��� <br />CITY '; P r �', STATE � ZIP .. <br />OWNER PHONE: ���� � �� �}� `� _ ,r,� �' �% �% OWNER EMAIL: <br />CONTRACTOR NAME: ,�, �-�-- ,�, � ;. r�;� r' ;-, � � � � � � � � <br />CONTRACTOR ADDRESS: sTReer 3 �� �-� � �%� �? r�� : �o � � / � ! .s � �� � � � � � <br />CITY .� ' �� F� �� ! STATE � ZIP t. � <br />CONTRACTOR PHONE: ! -� - i CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): /VI � �I i� t J/�'�I � ��i ���� �t. r'°� �( CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR �d OTHER (Please Specify) �6�v1 ' - 'r - , � <br />CONTACT NAME: CONTACT PHONE: ;^ , �' .�"`-,' � // ��� � <br />J � � � c �; � <br />�/�r�� �(� �i /' , ,_ %. ,,: CONTACT EMAIL: /�,j_ r ,/'✓ �c � ,� � �` _ <br />AGREEMENT: T hereby certifythat I have read and examined this application and know tfre same fo be true and correct. All provisions of /aws and ordinances governing tiris � <br />type of work will6e 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 pertormance of construction. That l am authorized by the owner of this property to pertorm the work for which application is made and l <br />comp/y with the Sfaie Contraciors Law 18.27 RCW and 296.200 WAC. <br />�� <br />`j� � � �� �, � , i ,;' � <br />�;' ,,;� <br />Owner/Authorized Agent Signature <br />Date <br />City of Everett Official Use Only <br />FEE <br />� 5� <br />�C�. � <br />PERMIT # <br />E � -- <br />(Revised 10/12/2015) <br />