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� <br />� <br />�ETRI AL PERMIT APP�LICATION <br />C C <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: � � I C3r��'l�� � � �%�— til�,�. ( I 6V �f' �I ���;� ) <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: '�Ci'�'k�I FI� � <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ C� <br />NUMBER OF DEVICES if low volta e: <br />FIRE ALARM? ❑ YES � NO <br />ASSOCIATED BUILDING PERMIT # if a licable :��f} <br />DESCRIPTION OF WORK: /�rw L�Ic'C�f�c.-�) � � , c„ c� v, +�' - c�i�. "`� C: a�.�e�' � r; �,3iv,� <br />c �1 ' 97 ��' N �, � h• \t �c r,� I hi..� c f�- ^.c .v�� Ginoi �^C�c�✓'- � S�rJ n IZ'c'-) ` <br />CONTACT INFORMATION <br />OWNER NAME: J��" �'\ ���jC _ TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srReer I I S ,� C? � S�r j�L. SG "�S� <br />p,q, �� <br />cirr � Ei/��' � sTn� �-✓/' ziP �c� �� <br />OWNER PHONE: LIC.�., y,�� -��� y OWNER EMAIL: �c�`jh�ti,,c ✓c_'1 M��� ,�v� <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: snzeeT <br />ciTv srarE ziP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(RE(1UIRED): CITY OF EVEREIT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: � OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: ('� "- ����i — j j� C <br />JL�Jp� �r�Jl��— CONTACT EMAIL: ,�J��+ �C•u,�r �,,�' � .,-r� <br />AGREEMENT. T hereby certify fhat I have read and examined this application and know the same to be true and correct. AU provisions of laws and orrlinances governing this <br />type of work will be completed 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 regulatrng construction or the performance of consiruction. That I am authorized by the owner of this property to perform the work for which application is made and 1 <br />comply with the Siate Contracfors Law 18.27 RCW and 296.200 WAC. <br />Signature <br />� <br />3//6 <br />City of Everett O�cial Use Only <br />FEE <br />`� i c� � G� =� <br />PERMIT # <br />E �� � %� � ��'1� <br />(Revised 10/12/2015) <br />