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�l,..ECTRICAL F'ERMIT 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: � � O /^ ^ �� � �� <br />BUILDING AREA (if residential, new construction, remodel, or addition) � Ci�� SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: I�COMMERCIAL <br />USE OF BUILDING: w�- <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ �� OQp <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES �O <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: ��(,� ��..i �� a.c, � �� 4,�`. <br />2 ►•�J ° �. l. `+-�.-- �✓t'�W�Q <br />� � �-C � � � 1 <br />CONTACT INFORMATION <br />OWNER NAME: � �v�, TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTReeT 3O� G�'7" /��.« ��i. <br />��.., <br />CITY l � / STATE � ZIP <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: � �C 1 I �� <br />CONTRACTOR ADDRESS: sTReeT �Z,�,� �2 D � � � <br />CITY /�/ V /Ci4C�- STATE � ZIP f��� <br />CONTRACTOR PHONE: `}Z,r � --(v�0'L CONTRACTOR EMAIL: i.� { �� G�-i-(, � C� i^-L. <br />CONTRACTOR LIC. #(RECIUIRED): � (�Qj DI/�l CITY OF EVERETT BUSINESS LIC. #(REQUIRED): `�'� 5�� � <br />PRIMARY CONTACT: ❑ OWNER '�CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: �'y3` � i� � —��(jL— <br />�J�� C <br />��„` V "\� C� I CONTACT EMAIL: �w �� � — _ (�,� � <br />AGREEMENT: T hereby certify that I have read and examined this application and know fhe 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 aufhonty fo violate or cancel the provisions of any other state or <br />local law regulafing construction or the performance of construcfion. That I am authorized by fhe owner of fhis property to perform the work for which application is made and I <br />comply with the State Contracfors Law 18.27 RCW and 296.200 WAC. <br />"�� /�, � ,�l � <br />City of Everett Official Use Only <br />FEE <br />�� � C�i <br />PERMIT # � <br />E ���'ol_ <br />(Revised 10/12/2015) <br />