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ELECTRICAL PERMIT APPLICATION
<br />ClTY OF EVERETT PERMIT SERVIGES
<br />32t}Q CEDAR STREET, EVERETT, WA 98201
<br />�P) 425-257-881Q � FAX 425-257-8857 ((E) everett�ps@ev�rettwa.gav � www.e�rerettwa:govfpermits
<br />PRtyJECT F,ITE INF�RMATlt7►t�t
<br />�PRo.��cT aQ���ss: 1 t.� � � � S� � .�'�t- 51,�,� � �,��e:t• e#� �� ti�- f') &a.���
<br />BUtLDING AREA (if residential, new construction, remodel, qr addition) SF
<br />BUtLDtNG TYPE: ❑ SFR-DE7ACHE� 0 SFR-ATTAGHED ❑ DUPLEX ❑ MULTI-FAMfLY -# OF UNITS: ,H�CC
<br />USE OF BUILDING: �,li t v i'�� �'t' � �\ 11 � C; �
<br />CONTRACT PRtCE flF WORK
<br />NUMBER E}F DEVICES (if lo �
<br />FlRE ALARM? ❑ YES
<br />ASSUClATED BUILDMNG PERI
<br />DESCRIPiIU flf WORK:
<br />�
<br />� � ��,� ��x����c� ��t
<br />I�L APPLiCATIdN INFORMATION
<br />1 \ � �� �,.-�� c.. 15
<br />2_) �`Ct�c�:�4,� ��
<br />, kC������.���_ {�� ��.�+�G� , �-�
<br />IAL
<br />, ,_._._ ..__. _.__,, ,,,,,, ,,,,,,,,,,,,a„ .,,,, a�,�,,,�a„v�r ar,u xreaw rne same ro oe true and correct AII proursions af laws and orciinances goveming this type
<br />of waie wrl! be Comp/eted whether specified harein or not. The granting af a perm7t does not presume #o give aufhority to vra�ate or eance! the provrsionS ot any ofher state or
<br />toca! !aw reguJating consUucfion or the perfo�nance of consfrvctron. That ! am authanzed 6}+ th� owner of this propeiiy to pertomr the work for which app/icebon is made and 1
<br />compJy tivith the Staie Gontractors Law 18.27 RCW and 296.2Qa WAC.
<br />OwnerlAuthorized Agelit 5ignature
<br />City of Everett Otficiaf Use �nly
<br />PERMIT # ?
<br />E �c� c � — �33 �.
<br />f� l�/�� ���
<br />Date (Revised 9/2312016}
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