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__.--.--._____. <br /> � • <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> j 320Q 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`lNF�iRMQT1�N <br /> PROJECT ADDRESS: �- ��,-�-� (,�, VL,Ju. <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: I�COMMERCIAL <br /> USE OF BUIL.DING: ��n�j <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ QQ(,� ��U-�,� 9� <br /> NUMBER OF DEVICES if low volta e : "'" <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT# if ap licable : <br /> DESCRIPTION OF WORK: , � :� S <br /> CONTACT INFORMATION <br /> OWNER NAME: {� f"Z Cc.,,,_ TENANT NAME(If Commercial): �� {h.�,("'��,�„ <br />� OWNER MAILING ADDRESS: sTFee.T a,�}- �. �, w <br /> CITY �,('�� STATE .i`� ZIP ; <br /> OWNER PHONE: OWNER EMAIL: <br /> i <br /> CONTRACTOR NAME: �� G�L'�iIrP�L, i <br /> CONTRACTOR ADDRESS: _ srREEr �oZS �/V��{�li f� �C.�/�. itC. �' ( I <br /> � <br /> CITV ,a�� STATE ZIP � <br /> CONTRACTOR PHONE: 02�� 3-^ �`�,�.— C7 CONTRACTOR EMAIL: v �� U S ll ��C �C�{„1't.�,��"' <br /> CONTRACTOR UC.#(REqu RED): �(,�j F.A,.)����jl�l= CITY OF EVERE BUSINESS LIC.#(REQUIRED): ��"�v' d,iZ <br /> PRiMARY CONTACT; ❑OWNER CONTRACTOR O OTHER(Please Specify)_ <br /> CQNTACT NAME: CONTACT PHONE: � _ .�7 -?�,... (CjCj S' <br /> ��tj�,`1[� ��.� CONTACT EMAIL: �} � ��S� �G� <br /> AGREEMENT:T hereby certi(y that! ave read and examined this application and know the sa to be true and correcL All provisions of laws and ordinances goveming this <br /> type of work wiB be completed wtether specrfied herern o�not. The granbhg oI a permrt does not presume ro give authority to violate or cancel the provrsions of any other stafe or <br /> local faw regulating construction or the performance ot construction. rhat/am authnrized by the owner o/this propQrty to perfo�m the work(or which application is made and 1 <br /> comply with the State Contractora Law 18.27 RCW and 296.200 WAC. <br /> City of Evereit Offrcial Use Only <br /> FEE <br /> --� <br /> � �2 �� <br /> PERMIT# <br /> _ .-� .� /��-( � � E �I �/�� � �'� (.i <br /> � <br /> ner(A orized Agent Si4�nature Date (Rovisod lU/12/2015) <br />