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RECTRICAL PERMIT APPICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits e. PROJECT ADDRESS: Se)Q BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL [USEF BUILDING: `�..,, „ a` �s.`Ycaw ELEC�,TRICAPPLICATION INFO`RMI ��D . . �...s fl INK CONTRACT PRICE OF WORK:$ V '00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: JVrtpjJLjjffL 3 0 , X' ' 1,c . � s � ONTICFORIiAATION ��x� � SUN ' �� ' OWNER NAME: 13 1ZVC-a oai' TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET „J 2 71 r-0 t lE�l'/ / yn CITY U LSTATE ZIP OWNER PHONE: 1OWNER EMAIL: CONTRALTO'., .. ...,.... .. .. ._.. ., . ........ ....._.. __._.. . ,., _.... _. ....., .... _... ... . . .... . .,.. R NAME: Lki-AN00A 661fa KKILY ALL CONTRACTOR ADDRESS: STREET CIN STATE ZIP CONTRACTOR PHONE: t6f Xrq CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): �-l�Atcf CITY OF EVERETT BUSINESS LIC.#(REQUIRED): d!(�JG PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.:Thereby 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 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 local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# E (Co 02) orb 0wner/ tIforized Agent Signature Date oo (Revised 10/12/2015)