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477- PLECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: EL,/1 i Li t ,/e Y C„rc`-€ 'iv' - - ~ �l <br /> BUILDING AREA(if residential,new construction,remodel,or addition) ( .;( SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: '_,c I;<F= ,_I <br /> (ELECTRICAL/APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: e:0c�,"" I <br /> NUMBER OF DEVICES (if low voltage): ...,..-- <br /> FIRE <br /> ALARM? 0 YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: i }p C V'c c>e p c dC e.L tr) 13 cT 14 rn j3 -f—ci Ac\C,) ta-Le..t. <br /> ._ (82, `> rr\_=�.+ t-(' p p L;Q,,t)cam= 1 Ci c c L, ,+S <br /> 2 ' \ <br /> CONTACT INFORMATION /7\ kf \ p <br /> OWNER NAME: TENANT NAME(If Commercial c <br /> OWNER MAILING ADDRESS: STREET \'N�CITY STATE --____ ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME. k/\y , Lc-c -- L L 1 <br /> CONTRACTOR ADDRESS: STREET I`�0 ( - 3/4_,* A\J c-?- , D. )V u 1� L`'- r� <br /> �t _-3 <br /> CITY �1 N I\) C.��'' CM �C 1 STATE (-`�� ZIP (�1� , '1p <br /> CONTRACTOR PHONE: " ir� ! f 0 <br /> a� �� 7 L4 -7DOC. CONTRACTOR EMAIL: lvI�''. L`L-L�'C� �t' � C O�� �-iGOt:T�i�EYZ[�LE'� <br /> CONTRACTOR LIC.#(REQUIRED):'V1 RE LEE F•cJC- ,0 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):`0 ( 3G, <br /> PRIMARY CONTACT: 0 OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT AME: 4F...... --' CONTACT PHONE: `..„a a_ 7 1 Lf. 70 Gtt 0 L� <br /> CONTACT EMAIL:rnr6,iPc-�v`11c ) �r�:T��_SCt<11.>/„ \ ; <br /> AGREEMENT.:I hereby certify t I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing t ih s type co " <br /> of work will be completed the 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 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 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E ��o9 _ �'cl <br /> Owner/Aut orized A ent gna a bate i (Revised 9/23/2016) <br />