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�ECTRICAL PERMIT AF�ICATION <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 INFORMATION <br />PROJECT ADDRESS: 1 Z�—�I 2vC.�f .Q� � �}- g � <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 />USE OF BUILDING: S'�� <br />CONTACT INFORMATION <br />OWNER NAME: TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTReer ��, A <br />CITY STATE ZIP <br />OWNER PHONE: �� ���O�I�j— t3 OWNER EMAIL: <br />CONTRACTOR NAME: � � (�(�L <br />CONTRACTOR ADDRESS: srREEr �'f '� � ,7—�� <br />CITY STATE ZIP � D !� <br />CONTRACTOR PHONE: ��' �'{$� �(pOOC7 CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): �L(�� �q S 5 �I/� K, CITY OF EVERETT BUSINESS LIC. #(REQUIRED): ��� <br />PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 3(�p �6Q� ��2 1 <br />� w` `N �'' CONTACT EMAIL: <br />AGREEMENT: T hereby certrfy fhat I have read and examined this application and know the same to be true and correcf. All provisions of laws and ordinances goveming this <br />type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authonty to violaie or cancel the provisions of any other state or <br />local law regulating construction or the periormance of consfruction. That I am authorized by the owner of this property to perform the work for which application is made and 1 <br />comp/y with the Siate Coniractors Law 18.27 RCW and 296.200 WAC. <br />OwnerllAilthorized <br />Date <br />Cify of Everett Official Use Only <br />FEE .� <br />� � �� <br />�� <br />PERMIT # <br />E ����- i��� <br />(Revised 10/12/2095) <br />