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��w�'` <br />v� <br />���TRICAL PERIViIi A�L.IC�4T'ION <br />C1TY 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 />PRO.IECT SITE II0IFORMiA"TIORI <br />PROJECTADDRESS: `', �rL--fj �C��"1�✓Y1G�i'(� f1-VC� <br />BUILDING AREA (if residential, new construction, remodel, or addition) 6I�Tc4:-1ti�tY ���' `�' ` <br />BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UN <br />USE OF BUILDING: <br />❑ COMMERCIAL <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ �� y ����Ca <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES O <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: j`V' l� C�,i�P�( ���, �� L I� GE� G' <br />�t ��,� / � I 'i.�% ,� <br />CONTACT INFORMATION <br />OWNER NAME: G �" � '�j TENANT NAME (ff Commercial): <br />OWNER MAILING ADDRESS: srReeT U f1 ' �'�L�� <br />CITY a CC_- STATE <br />C+�' c�- '� �� z�P (�Y <br />OWNER PHONE: � f) I' ��L'A � OWNER EMAIL: <br />_ . _.. __. . ��v ...�. . _, :_ ,:. ,. _.. . ...._.. . .. <br />,. _ ..._. _ . ._ . ..._.... �........ .. <br />_ _ . _. _. <br />CONTRACTOR NAME: i�' �Cl� C- i[-� �j�t�� �-�''�� L. I,-- C.� <br />CONTRACTOR ADDRESS: s-rReeT �)� Gf� � I�C W <br />CITY �.`�� STATE ��'( S 1h ZIP g� a <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): IJL.'�jC �C-�� �'� CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 'Z�,�j �^ c'�J,�"7�' <br />� �� � � � ��,�,� �t�, CONTACT EMAIL: <br />AGREEMENT: T hereby certify thaf 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this <br />type of work will be completed whether specified herein or not. The g�anfing of a permit does not presume to give authorify fo violate or cancel the provisions of any other sfate or <br />loca/ law regulating consiruction or the performance of construction. That I am authorized by the owner of this property to perform the wo�k for which applicafion is made and l <br />comply wifh the Siate Contractors Law 18.27 RCW and 296.200 WAC. <br />Owner/Authorized Agent Signature <br />� '' l-� '.� <br />Date <br />City of Everett O�cial Use Only <br />FEE `� <br />�� ` <br />PERMIT# <br />� ���� "��U <br />(Revised 90/12/2015) <br />