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�.ECTRICAL PERMIT A�L.I�ATIplU <br />e�-rY c,� �u�R�rr P��n���r ���v�c�� <br />32{}t3 GEaAR S`CR�ET, �VER�TT, V�';�A ��2Q� <br />{P) ������7-8810 � FAX 425-�57-88�7 �(�) ey�r€���ps�,,7a ev�rettwa,gov j�nrw.evere#twa.t�r�ul��rmitis <br />PROJECT AflClF�ESS' �� �, � � .� i' � . <br />`; ° <br />BU�LD�NG AREA {if residentiat, new cans#n,i' ' n, remodei, ar addit <br />BUILLIlNG TYPE: C� SFFt-aETAGHED C� SFR-ATTACHEt7 ❑ <br />�:c�NTRACT PRlCE OF WORK: $ <br />NUMBER t�F CtEViCES (if law voit� <br />�iRE AL.AR�VI7 ❑ YES <br />ASSO�CfATEp �UiLD�ING PERM(T <br />D��CRlPTIC3N fi� YUQRK: <br />� <br />� <br />�NER MAILING ADDitE$S: s���T `�;�,°`� <br />crrv .��r' �'-�' `i`�� ' <br />tNER PH4NE: �,,t� --� �� G� � ...,. �~��^�. <br />_ _ <br />�, � _. <br />NTRACTf3R NA�IfIE: . �-�,��� i �-�, . �� . _ a� <br />� STREE7 <br />CI7Y <br />OWNER EMAI�.; <br />C� MULiI-FAM!!.Y - # f:1� t�NtiS <br />!%EAME <br />STATE <br />STAT� <br />L7 CGiM�ERClAI. <br />ZIP <br />r'� <br />� � � �'�" ,"' �.�e"'""-' � = �`•'�' ���,�� � � tr t"i"t i�.:� C.. 3` E � l <br />CC?h1TRACTC3R l.IC. iX�R�QUtRED}: '� r / `�{ ;,� `�. �,.�.`,� . <br />� C���> CITY C)F EVEI�ETT Bt�Stiti1�SS LIC. REQU�RED ; °� �� <br />PRfA+tARY CQN�'AGT: _QWN�R C� GC3NTRA�TOR ❑ t�THER ��lease Specify) <br />CQ1�tTACi NAM�, CONTACT P�C?lV�: '� �� „m � �� , .� -: ' �:. <br />�0 <br />c���,��°� _ " <br />�� ��� �.�' Gt.}N7"�lG�` EMAI�. �- - � . <br />� �� � � � �`;� :� ,.�..:.`_ 3 �-`�= o..���ff���� <br />A GR��M'ENr> r ner�aby cert�fy tir�t r have re�d e�na ���raair�ed thr's �pplrc�rlQn and rvrow rn� s�rr� fc, t�e tr�re ana s�rr�cf. A1r �r�vl��zs c,T ���vs anrt rrro',nancss <br />l�re �+f w�ark wrfi,b�r er.�rnpf�si7 ��fher specli`ied ir�taa'r� c�r ns�t. ih� parttir� a€a ��9��'���i� this <br />krc�t 1sw r�eyulafiru,� caa�frv�z'rQn �r fhe pertqrmance r�f corrstru�#ian. � hat t am au3horr`zed� ��Eh,��t�wrr� af tirs r`�re �utftar��'y to vic�t�fa z�r �anca! ihe provisions rn` arry e�;her sta�e ar <br />�*P�Y �vrtfr �he Stat� ��rslre�Gtors Law t 8. 2T RCi�t� and 29�.2t?Q WAC, � F+'�Ae�Y t4 A�`rh�rm ftr�r wor�t fc�r whieh applicaPtan Is rrr�de �nct i <br />�wnerfAutharized Agent Signature dgt� <br />GtYy ot Evereft Offiofat Use tlnty <br />�EE .�....._�`....�" <br />� �`� � � o <br />� <br />�����r � <br />��� <br />� l ��-(�_ <br />(i2esrlssd 1DI12l2Q15) <br />