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4LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425257-8810 FAX 425-257-8857 (E)evereti:eps@everettvva.gov J vAm.everettwa.gov/permits <br /> PkOJECT ADDRESS: <br /> BUILDING AREA(if residential,new constrUction, remodel,or addition) SF <br /> BUILDING TYPE; 0 SFR-DETACHED ❑SFR-ATTACHED I1 DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: iAL <br /> -„s��lsltr�{,,,:r�'k •EI I{, , .+fUi;6ltA ,;P +,r� i t, <br /> 1I ', (I A- S `g�ll�atE {E,'Iyypp a I1 ,Itfrl li i. g,,,tti,j4',,I s` '4,y <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES if low voltage): L <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT If alivable ; <br /> DESCRIPTION OF WORK: <br /> VS1Sii 1',(r1 �t.,,rsus , <br /> . .^ ..f�,1,; <br /> ' <br /> OWNED NAME, <br /> /v IJ C TENANT NAME If Commercial : S �— <br /> OWNER MAILING ADDRESS: STREET <br /> 7 <br /> cfTv <br /> STATE ZIP <br /> OWNER PHONE. OWNER EMAIL: <br /> CONTRACTOR NAME: iQfJ cue l`( I ,(, <br /> CONTRACTOR ADDRESS: STREET S r 'cA' Q <br /> clTv CQ3A <br /> 7,IF' <br /> CONTRACTOR PHONE; CONTRACTOR EMAIL; STATE ``�� <br /> CONTRACTOR LIC.#REQUIRED: Z CITY OF EVERETT BUSINESS I-IC.#(REQUIRED <br /> PRIMARY CONTACT: U OWNER 'vQ'bpNTRACTOR ❑OTHER(Please Spoclfy) <br /> CONTACT NAME: CONTACT PHONE: t) <br /> LAAr1 <br /> - C ( CONTACT EMAIL: r � <br /> AGREEMENT:Thereby certify that i haven reed and axamint?tl this a r <br /> type of worlr will ben eomplefod tvhetht�r s ec!!r Aplica8on and know the same to be true and correct, All provisions of/aws and orefJnances govemirg this <br /> local taw regulating construction or the pprforrnsnco of construction, ThatwrantJng I am a Permiauthorize <br /> do not preau7a to give authority to violate or cancel thA provisions of sny other state or <br /> Comply with the State Contractors lt♦W 18.27 ERCW ane'298.200 WAC. m author!;Cd b the owner of this property to parform the work for which application Is made and I <br /> City of F-varett ONICIal use Only <br /> FEE <br /> PERMIT# <br /> 1 Owner/Authortred Agent signature �I <br /> Date (Revised 70/12/2075) <br />