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• • <br /> ��,������A� ��� I� ������/�1�I�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMA°TION <br /> PROJECT ADDRESS: ��-��- �3� � �� C J`�'C-�� , f�� <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> 1', <br /> USE OF BUILDING: �;�LQ,,,> 7 �}L�r <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ (�y UUCs <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES E�NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �e 7(�L ,,,,� -�- : • to - � � �1.�t ' • . I,'�C`�( �- �- <br /> CONTACT INFORMATION <br /> OWNER NAME: rL•.�.c�t���L �� 1 4 i�'� rer; TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ��C{�}- �/CctT� L <br /> � <br /> CONTRACTOR ADDRESS: sTRee-r 'S_(../ � �r t ��J� <br /> CIIY .C/r/ �i( T 1 t STATE LJ r� ZIP /�(IJLj <br /> CONTRACTOR PHONE: ���. ``C�=`_>Zl•— 3� CONTRACTOR EMAIL:��+�� . 'P�`�� , _� - r ✓�-�-4rC0-� <br /> CONTRACTOR LIC.#(REQUIRED):VtC.J���.��ILAd l„1 CITY OF EVERETT BUSWESS LIC.#(REQUIRED):GY) S <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Zp�y --�,�j.��� 3� <br /> �E�SC;� �L'J�oC.:st���(� CONTACT EMAIL:���-rn� `�CPte�.vr�c lc.l `'J �.GC�LL <br /> AGREEMENT I hereby certify thaf I have read and examined this applicatron and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work will be 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 1 am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the Stafe Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> �' PERMIT# <br /> '� �o . � � �1 I � �2�� <br /> , z�r 1 <br /> O er/Authoriz ge Signature Date (Revised 9/23/2016) <br /> I� <br />