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fLECTRICAL PERMIT A4ICATION <br /> E CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: e`��o �N 5,-r <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE SFR-DETACHEDPM-SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: 45F <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ o�. <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑ YES O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �iDD/�/c A �iI/LG�/T /��- A �✓E�•✓ ,d�G Sf N4A-r <br /> CONTACT INFORMATION <br /> OWNER NAME: F-4L-r TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET I S ` TN 5-r � gig <br /> ,LpCITY lrVleli�-f- STATE ZIP <br /> ! <br /> OWNER PHONE: �����`YO (IV I-- OWNER EMAIL: <br /> CONTRACTOR NAME: UAIDANIC- �J�/ C �Gfif <br /> CONTRACTOR ADDRESS: STREET t�7)/_�'—Ya M&Ald�� <br /> 007 � <br /> '! /CITY 4"64 LL- STATE �/� A ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: �1��'�� / � CiMf/J- f/'M <br /> CONTRACTOR LIC.#(REQUIRED): 5j4AJbAe-5-0&2--S'9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Lr->S1�-- <br /> PRIMARY CONTACT: ❑ OWNER NTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT:T hereby 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> Owner/Authorized A&XI <br /> gn re Date (Revised 10/12/2015) <br />