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,; <br />� 1T APP�ATI�N <br />, �ECTRICAL RE�M <br />� <br />; '` �►TY C)F Eii�'RE7`T�'�PERMIT 5ER�1J��S ` <br />� 320(� CEC?AR STR�ET, EVEf�ET'T, WA �82C11 <br />����� (P} 425-25z-8s3� � FA� 425-257-8857 �(E) everetteps a�eversttwa.gov � w�nrw:everet�wa.govlperrni��s <br />PROJECT SITE 1NFORMATION <br />PRQ.lECT AQDRES3: C� ( �'- i_ � `V C.�� � "' ! � ,. <br />BUfLD(NG-AREA {if residentiai, new eQnstrUctlon, remodei, or addi��on) �� ��� �� SF �� <br />BUILQING TYPE: Cl SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MUI�TI-FAMILY -# OF UhiITS: CI COMMERCIAL <br />i.lSE OF BUIL.DING: (G'� �� i� t�L�Y�i� i r ./{i'r �% vt,_.,�r c. � � <br />� � � � � � ELECTRICAL APPLICATION INFORMATION ��� � � �� � ���� � � <br />CONTRACT PRICE OF WORK: $ �� <br />NUMBER OF DEVICES if low volta e: <br />FIRE ALARM? ❑ YES �{+10 <br />ASSOClATED BUILDING PERMIT# if a licable : <br />DESCRlPTION QF WQRK: � C�/ iI fP� �°� � rc%"`t�'l t�' j,� � �^'` �. / <br />- � r� <br />� '���� GON'iA�T IN�f�RMAT�QN'���� <br />OWNER NAME: �,S�It, J.� V�/�� T�NANT NAME If Gommercial ; <br />QWNER MAILING ADDRESS: srREEr !���}���% 7�l �'� <br />. .. CITY ..� V V t/� ��. . � .. S7ATE` � � � �ZIP � u��� ��� <br />OWNER PHONE: ��-� OWN�Fi EMA►L: �/ TY-- <br />' CONTRACTOR NAME: � �Ic. C���' C' <br />CONTRACTOR ADDRESS: srrt�Er %�.� ,� ��� �� tJ C <br />cirr .G�--,G'L,• 1�' ��`tf'L'��i,G'f.� s�nr� i�/i� /�' z�� �' ���� <br />CONTRACTCIRPHONE: t"7�����'MG��1� GQNTRACTC}REMAILi �L'IC��i,,�C�IYJ �P'�ifU�G"�"J�"j�-.�"""/ <br />CONTRACTQR LtC. #(REQUiRED); l� ���%��ZC�G GITY f3F EIJERETT BUSINESS LlC. #(REQUlRED}: �'7���:i� <br />' � PRIMARY CON'TACT: ' ��D OWNEi� � CC��7"RACTOR ❑ OTH�R (Pleasa Specify) �' <br />GANTACT NAME: jf�� ( � CONTACT PHONE: .��� -- �-�,� ,,.,,:� � ?�.. <br />l <br />rL/ �f r'�' '- x y ' GONTA�T E1�II,�kIL: ��'�'G��� �� <br />�If;R�Fhk�IiT� f aarah�:,-�rtu,'.3h�r i r�-„�o .o��t-,,,:-z�.���.,..r n.�r�.rt,��. �,,.,r:-.�w;.... e.,.�e��. uHn�.aaik.^'� „n.... u_ r.:�� ,_ _ . . . . .>. , . > > . . . � . ,- , - <br />;-"�/ <br />,�-'"� <br />� � ��� <br />Hr�er� ulhsiriz A�ant ��r�,a e�� � Daie <br />� <br />� <br />� . ���� _� �. <br />CiFy of Everetf O�alat Us� !'Jn1y° -, <br />