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�ILECTRICAL PERMIT A��LICATION <br />CITY OF EVERETT PERMIT SERVICES �.,,��c� l*�,� �� <br />3200 CEDAR STREET, EVERETT, WA 98201 � ��`�}-,. C�Cp <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: �•%' • <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: <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): � y-- � <br />DESCRIPTION OF WORK: fl 'Z� . � ��-- � �L.+�/V-� <br />� � L.�I.� \ ' '� � d G��> % V • v � <br />� �b <br />CONTACT INFORMATION <br />OWNER NAME: ,S � � Cj TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srReer � L. � jZ <br />CITY 'S� STATE `C` ZIP ' �2d� <br />OWNER PHONE: �t .- �? c'3 -Q �?� OWNER EMAIL: <br />CONTRACTOR NAME: �} I \ -� `, .*3 • <br />CONTRACTOR ADDRESS: s-rReeT �j� �/ � � -l� f� <br />CITY �' � 'j�"'e.� STATE �.I�� ZIP ��0� <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: � v��S v� �� �' N� Y�'�1'v1Ct t, C.0 <br />CONTRACTOR LIC. #(RE��Fh��)�� �G �/ � K Ci� CITY OF EVERETT BUSINESS LIC. #(REC2UIRED): ��� '�JI� <br />_ __ _ ._ _ _ _ ___ _ <br />PRIMARY CONTACT: � OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE; t,�'Z,= ZZO--Q-335y <br />,� � 1/�,`, CONTACT EMAIL: <br />-� � •�. ,: a <br />AGREEMENT: T hereby certify that 1 have �ead and examined fhis application and know the same to be frue and correct. All provisions of laws and ordinances goveming this <br />iype of work will be completed whether specified herern or not. The granting of a permit does not presume to give authonfy to violate or cancel the provisions of any other state or <br />local law regulating construction or fhe performance of consfruction. That ! am authorized by the owner of this properfy to perform the work for which application is made and l <br />comply with the State Confractors Law 18.27 RCW and 296.200 WAC. <br />Agent S�gnat�re Date <br />Ciiy of Everett Officia/ Use Only <br />FEE <br />� 'l �� � <br />PERMIT # <br />� �� 1 � E _ �� ' C�� (� <br />(Revised 10/12/2015) <br />