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LECTRICAL PERMIT4PPLICATION <br /> CITY OF EVERETT PERMIT----: VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 (E) everefteps@everettwa.gov j Www.everettwa.gov1permits <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> B <br /> LDIN El COMMERCIAL <br /> BUILDING TYPE: [I SFR-DETACHED 0 SFR ATTACHED El DUPLEX VMULTI-FAMILY- OF UNITS: <br /> USEE OF BU <br /> SE OF BUILDING: <br /> q <br /> IE <br /> OA,`W-Aff A...... <br /> R. <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? 0 YES ONO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: - (-) k�*, Akio:0 <br /> C0 <br /> qT0 <br /> - I -h - <br /> ffNER-NAM@e. VZ TENANT NAME(if Commercial): <br /> OWNER <br /> N-A LkQP—\<'1 <br /> OWNER MAIUNG ADDRESS: STREET V,K\1A,V. <br /> ST'111 Zip <br /> OWNER PHONE: IOWNEREMAJL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET )0_RO)( <br /> CITY ACAQV-� STATE zjp <br /> CONTRACTOR PHONE: ICONTRACTOR EMAIL: <br /> ICONTRACTOR LIC.#(REQUIRED)- CITY OF EVERETT BUSINESS LIC.#(REQUIRED),. 0'21(66 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: I? CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEmENT.T hereby ceifty that I have read an4 examined this appricalfion and know the same to be true and con-ect. All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein ornot The granting of permit does not presume to give authoiffy 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 ofthIs property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> E <br /> "Date (Revised 1011212015) <br />