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ELECTRICAL PERMlT ,_;. PLICATIQN <br /> Ey CITY OF E`✓ERETT 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 INFORMATfON <br /> PROJECT ADDRESS: + "�,. '7 "/�.e�7 �, '� +� ��4�'t°+�C' � � <br /> BUiLDING AREA(if residential, new construction, remodel, ar additioR) .0�''�4+✓t'�"W'} �`/6F �., <br /> BUiLQfNG TYPE: ❑ SFR-DETACHED � SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMI�Y-#OF UNITS ❑ COMMERGIAL <br /> USE O� BUILDlNG: („�1L,✓� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low volta e): <br /> FIRE ALARM? ❑YES � <br /> ASSOClATED BUILDING PERMIT# (if applicable): � / L� - ;1 ��!/ �� j 'Qj <br /> DESCR(PTION OF WORK: '�. n�Cy" ,Y'A�'!? 1`G�i �r/'aK �"�/� r, <br /> � r ` 6a�`�a^t ,�. �/' �� .�' � �,., <br /> 1 A �t, `' '° Y�d�,.'1%Y' K�i�'4 G�rj , <br /> CONTACT INFORMAT10rN <br /> OWNER NAME: ei" TENANT NAME{If Commercial): <br /> OWNER MAILING ADDRESS: sr=eer '�'2-(n f $ <br /> -, '"�L�1`s,.,� s' - -- �'�.�F.a'. <br /> OWNER PHONE: ���' �`1 �'�/ j OWNER EMAIL: I C7.'a!��+' l7pY! mp rr/� ("fJrh <br /> CONTRACTOR NAME: �! �t�"G� <br /> CQNTRACTOR ADDRESS: s??rcT <br /> ��r�y S7:.TE =!P <br /> CONTRACTOR PHONE: GONTRACTOR EMAIL• <br /> CONTRACTOR LIC.#(REQUIREDi: CITY OF EVERETT BUSINESS LIC,#(REQUIRED): <br /> PRIMARY CONTACT: �INNER ❑ CONTFZACTOR O OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �,��^ 7'T,�� j9'�f <br /> �C ' �.�,�,,•�s��G-�" CONTACT EMAIL: ��� ��� �,�,,�J <br /> AGRcctvfE�'�'L �irar�by cer,ify;hat i have read ano examined th�s applica;ron and nno��t�.ne s2rr>e;o oe tr�ie af�ri correcr At,prev;s;ons ol lav;s and orctv,arces�overrrrg tnrs <br /> !ype of worx wil;h,e completed wiiether speciilea here:n or�a `ha grannng of a perm�t does no,presume tc grve authority ra•nn;are or cancel;he provisio�s o1 any oLber stat2< <br /> !oca%la�:�regulaUng cansi�ucoon or tne Fnr�ormance cl consvuc,'�or, `hat�am aurhonzecl by!ne a�,vne�of!nis p;�oper�y�ro��ertorrn thE tvork For;mhrch app�rcaGer,,s made and! <br /> r;pmply with fne 52ate C;onUactors La�.a� '8 27 RCW anq 296 2C0 WAC <br /> Q,ryol Eve�en. ��Ffrcral Use Onty <br /> � �4! ��� C��� {''��`''C� ����ylt'%�"i� FEE� �La <br /> � �� . � <br /> PERMIT# <br /> �.---�-�. �.,�'.____.-...-�--=�� �.- , �_�� E � ��0 Z- l b I <br /> OwnerlAuthorize _.gertf�S' lture Date ;Re�rsed 1U/1'L�2015i <br />