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�ECTRICAL PERMIi A�LICATION <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 />PROJECT ADDRESS: ��� J4� �j->C � n = �' � `� � Z%� �' <br />BUILDING AREA (if residential, new construction, remodel, or addition) "�,��, SF <br />BUILDING TYPE: ❑ SFR-DETACHED �SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-# OF UNITS: ❑ COMMERCIAL <br />USE OF BUILDING: �y(�1�,'y[,�-_ <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: �—y�-,� . - ,,,,_, � ,J � ,-�� � ,� � �, � <br />yiti ' I r.l. JU--T L� t' � �—1 n) :– i'�a2- Si:� `��' Li � <br />_Tb - �' � � �G' <br />CONTACT INFORMATION <br />OWNER NAME: ""�;' �- ��.- ,. �� �,��U -." TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srREE-r - �''�-�:� C, "�' ��.�5 <br />CITY STATE ZIP <br />OWNER PHONE: �{ Z J �� 30 -� I �(3 OWNER EMAIL: t�? ; cc� )c '� ��, c- :.'::�I. L�.ti-,ti <br />CONTRACTOR NAME: ' ,;� ���; ; ��'�� <br />CONTRACTOR ADDRESS: sTREeT <br />GTY STATE ZIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: 4�OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAIL: <br />AGREEMENT: T hereby certify that I 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 authonty fo violafe or cancel fhe provisions of any other state or <br />local law regulating construciion or the performance of construcfion. Thaf 1 am authorized by fhe owner of this property to perform the work for which application is made and 1 <br />comply wifh the State Contractors Law 18.27 RCW and 296.200 WAC. <br />L� '� <br />orized Agent Signature <br />City of Eve�ett Official Use Only <br />FEE <br />__l � �, <br />o_ <br />PERMIT # <br />E (�ai�� �� <br />(Revised 10/12/2015) <br />