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From: 02/16/2016 16:02 #039 P.002/002 <br /> • i <br /> ELECTRICAL PERMIT APPLICATION / <br /> I�►` - CITY OF EVERETT PERMIT SERVICES �'16 D.-0;R <br /> 3200 CEDAR STREET, EVERETT, WA 98201 2 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> •::�::°::'•:`F!RO.IEC'i":;�IT�.INF...©. -NATION.'. <br /> PROJECT ADDRESS: 5\(`y `�'� C <br /> BUILDING AREA(if residential,new construction,remodel,or addition) ,- ¶H --) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: (`COMMERCIAL <br /> USE OF BUILDING: \:::Z.‘Q `\ <br /> ........ ... .. <br /> L CTRICAL.'APPLfC.AT.ON:INF•.INFORMATION <br /> CONTRACT PRICE OF WORK: $ \ <br /> NUMBER OF DEVICES(if low voltage): \ <br /> FIRE ALARM? 0 YES 1,NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: N1 "-\ 3 c <br /> : :.CONTACT.INFORMATION . .. ..:. :.. . ::... :•°::: : ; <br /> OWNER NAME: \ TENANT NAME(If Commercial):\ <br /> OWNER MAILING ADDRESS: STREET ` \5--\\\\, �� <br /> CITY �```_\`t r \C-1 STATE ZJP O r <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET ( <br /> CITY yyA�`-_] *0 STATE <br /> CONTRACTOR PHONE:94t" -toC.+`` -1-\0Cj 1CONTRACTOR c s c Cnt`f� <br /> CONTRACTOR LIC.#(REQUIRED):c�`�j�� C �7��(��� CITY OF EVERETT BUSINESS LIC.#(REQUIRED):AAC2,'7 <br /> PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:cg � 4 ��_ <br /> CONTACT EMAIL:Cs,v.,c'\c-_,S©� 1` \ ..�= \6a <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. Aeprovisions 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 /> tgb,,°C <br /> PERMIT# <br /> E 1(oQ - Jl0 <br /> Owner/Authorized Agent Sig a � Date (Revised 10/12/2015) <br />