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�,ECTRICAL PERMIT A�ICATION <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 />�..�D PROJECT SITE INFORMATION <br />PROJECT ADDRESS: F Wi /! /�i ��� <br />BUILDING AREA (if residential, new construction, remodel, or addition) -%�O SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: .�COMMERCIAL <br />USE OF BUILDING: C� l`,= n� j G�i��:���� <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ �U �G'�? -- <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES „�"NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: /�'�7U ` /��',5; �%�7 /EG �. �� �/.uC <br />U �'F/� �� <br />CONTACT INFORMATION <br />OWNER NAME: /V�,� %ir i.�.i.�'S� /:�u s C`"�nl�J: i GI.J,v�/ TENANT NAME (If Commercial): ;�! �^' <br />OWNER MAILING ADDRESS: srReEr �, ��/ /y�'�✓, %% /-t i� F <br />F I%,�J���� CITY (,(,//� STATE y�ZC�%� ZIP <br />OWNER PHONE: .�G�U ��1�� /� 5 OWNER EMAIL: <br />CONTRACTOR NAME: United Electric Contractors , Inc . <br />CONTRACTORADDRESS: sTREer 53U1 South 2nd Avenue <br />cin, Everett STATE WA ziP 982G3 -4112 <br />CONTRACTORPHONE: 425-252�-7811 CONTRACTOREMAIL: unitedelectric@comcast.net <br />CONTRACTOR LIC. #(REQUIRED): UNITEEC 176 M6 CITY OF EVERETT BUSINESS LIC. #(REc1UIRED): 019434 <br />PRIMARY CONTACT: ❑ OWNER 9 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: Dave Hammer, Principal CONTACT PHONE; 425-252-7811 <br />CONTACTEMAIL: unitedelectric@comcast.net <br />AGREEMENT: T hereby certify that 1 have read and examined this application and know fhe same to be true and correct. Al/ provrsions of laws and o�dinances governing this <br />type of work will be complefed 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 consfruction or ihe performance of construction. That I am authorized by the owner of ihis property to perform the work for which application is made and l <br />comply with the State Contracfors Law 18.27 RCW and 296.200 WAC. <br />Owner/Authorized Agent Signature <br />City of Everett Official Use Only <br />FEE <br />� �{ � � U� <br />� <br />PERMIT# <br />E'� ���_ C � � <br />(Revised 10/12/2015) <br />