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ELECTRICAL PERMIT PLICATION <br /> CITY OF EVERT PERM R <br /> ETVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425.257-8810 [ FAX 425-257-8857 ] (E) everetteps@everefwa.gov] www.everettwa.govlpermits <br /> PROJECT ADDRESS: <br /> r <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: Q SFR-DETACHED Q SFR ATTACHED Q DUPLEX MULTI-FAMILY-#OF UNITS: d4' LI COMMERCIAL <br /> USE OF BUILDING: <br /> Y"M <br /> 4 r_ <br /> CONTRACT PRICE OF WORTS:$ <br /> NUMBER OF DEVICES (if low voltage). <br /> FIRE ALARM? Q YES ONO <br /> ASSOCIATED BUILDING PERMIT#Cif applicable): <br /> DESCRIPTION-OF WORK: N } — <br /> E!DW <br /> i� TENANT NAME(If Commercial): <br /> a= L1 U ck -- <br /> NG ADDRESS: STREET61� , Qy <br /> ZIP <br /> E: �C- OWNER EMAIL: <br /> CONTRACTOR NAME: .%v`�% <br /> C-' <br /> CONTRACTOR ADDRESS: STREET <br /> cnY \P1 STATE ZIP <br /> 7-7 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> #(REQUIRED). CJ <br /> _ � <br /> CONTRACTOR LIC,#(REQUIRED}; �. 11 CITY OF EVERETT BUSINESS LIC. <br /> PRIMARY CONTACT: Q OWNER a CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: GONTACT PHONE: l� <br /> �r CONTACT EMAIL: 1 �`L?�l�C1� C . A <br /> AGREEMENT.'Thereby certify that I have read and examined this apprcation and know the same lobe 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 notpresume to give authority to violate or cancel the provisions of any otherstate or <br /> local law regulating construction orthe performance of construction. That 1 am authorized by the owner of this property to perform the work forwhich appicatton is made and I <br /> comply with the State Contractors Law 18.27RCWand 296.200 WAC <br /> City of Everett Official Use Only <br /> FEE rO ✓�j <br /> \ � <br /> PERMIT# <br /> Oirvner/Auf6oriz Agenfi Signature.: Date (Revised 10/1212015) <br />