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SP' • ELECTRICAL PERIM T•PLIC TION <br /> ,.` <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 1 www.everettwa.gov/permits <br /> PROJECT SITE i'E IINFOR4lf1A T�I,IN <br /> PROJECT ADDRESS: .v 506 Giteg-in t f ST J &ve_re_ -', IA) A- <br /> BUILDING AREA(if residential,new construction, remodel,or addition) 1 n d!' SF <br /> BUILDING TYPE: XSFR-DETACHED E(SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): // //�� <br /> DESCRIPTION OF WORK: ge P''e( / 0( nneck.) o(,A-le rl€ie; t n <br /> /i - s c;,r . new pnke[LD' ` <br /> del•e rs/ e/e c-Lr(c -�rna�-� <br /> :.....CONTACT'INFORMATION. <br /> OWNER NAME: �/ L., )Li 0/A-C-- TENANT NAME(If Commercial): `.... <br /> OWNER MAILING ADDRESS: STREET" 13o27 3 rc( ,4v ti e. <br /> crry JW rt/S v(l it- STATE td,Aet ZIP g 27 I <br /> OWNER PHONE: 1425- `8-70 63'/0 / OWNER EMAIL: 6'GC'S'eik,e-// ,ko4" 6x.//,cool <br /> CONTRACTOR NAME: I 0 Go/ti t - <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: XOWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 'Z5 isz9 (. 3 4/0 <br /> / 0l4 y el w Gl CONTACT EMAIL: Gt--04/ I( /1-VT/-71_c i ( -- <br /> AGREEMENT::T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type 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 performance of construction. That lam 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 /> FEE <br /> PERMIT# <br /> _ ',,,f_a_..)0 3/I(r7 E <br /> . wner/Authorized Agent Signature Date (Revised 10/12/2015) <br />