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�ECTRICAL PERMIT A�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 />PROJECTADDRESS: ��aa "�� �"� C.`' <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: ❑ SFR-DETACHED '�Q SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL <br />� <br />USE OF BUILDING: �„Q, <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ p� .`� <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: � � <br />AGREEMENT: T hereby certify that 1 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 1 am authorized by the owner of this property to perform the work for which application is made and I <br />comply with the 5tafe Contractors Law 18.27 RCW and 296.200 WAC. <br />Agent Signatu <br />Date <br />City of Everett Official Use Only <br />FEE <br />� �� �� <br />C <br />PERMIT # <br />El � � �b�� <br />(Revised 10/12/2015) <br />� <br />