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ELECTRICAL PERMIT A16LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-287-8857 1 (E) everetteps@everettwa.gov I wvw,r.everetfi��a.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: +C> ) i Yl-' BUILDING AREA(if residential, rew construction, remodel,or addition) SF L ING TYPE: ❑ SFR-DETACHED ❑SFR-A T rACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL F BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if IOW v01ta e): FIRE ALARM? ❑YES El NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: L�occ� Z. a�� X13 Q di ra t� v . CONTACT INFORMATION OWNER NAME: IAC i31i C:�C� CY�G TENANT NAME If Commercial): OWNER MAILING ADDRESS: s -c crr STATE Z- OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: r� E(�(,^�L - CONTRACTOR ADDRESS: d �} �" MATE Vti/�"C' PCONTRACTOR RACTOR PHONE: 44-43(0• 2-0() �P �Qlb CONTRACTOR EMAIL: LIC.##(REQUIRED):V CCC-cC.L.s�{2 AN CITY OF EVERETT BE4, '`.F4 SRY CONTACT: ❑OWNER `CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ZOO, SS Sr' CONTACT EMAIL:REEME/UT.Tterebyce.tifyfnatlnave eadandexamlr, ed this application and know the same to be true and correct All prov,s,ons of laws and ordnances govemino tris type of work will be completed vvhetirer 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 local law regulating construction or the parson nance of construction. That!am authorized by the owner of this property to perform the work for which application is made and comply with the State Contractors Law 18.27 RCW and 296.200 WAC. Cry of Everett Official Use Only Es _ PERMIT* Owner/ orized Owner/Owner/ ant ee (Revised 1o11Z2o15)