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__ _ . ___ _... <br />�.�ECTRICAL PERMIT APF�L�CATIQ(� <br />CITY OF E=VERETT PERMiT SERVECES <br />32Q0 CEDA�t STREET, EVERElT, WA 98201 <br />tP} 425-2�7-881fl { FAX 425-257-8857 �(E) everetteps@everettwa.grsv � www.everettv,ra.govlp�rmits <br />', �1� � ,��.'�'�� �;��a.�E�T s�-rE i�wFo�n�aT�c�� <br />��t�a�c� ��t��t�ss: , � m �'��� �`�� � ' �.�; � ���. <br />i., <br />SUiL�kNG AREA (if resitlential, new construction, remodel, ar addi#ion) SF <br />E3UIILDING TYPE: Cl SFR-DETACFiED 0 SFR-ATTACHED � DUP�EX � MC}LTI-FAMILY -# OF UN{T5; � COMMEFtCiAL <br />UJC �� �U�ILYiRYV. �T F, 5"^a.�r t ; . , . i. . . o' � ` ��_ <br />' ELECTRlCAL APPLICATIIDN IN�AR1ViATIQN - <br />�ONTRACT PRtCE fiF WQRK: $ � ` <br />NtIMBER OF D�VICE� (if low voitage): ��,t , �; <br />FIF2E ALARM? ❑ YES �l NO <br />ASSdCIAiED BlJELDING RERMIT # (if applicabie � <br />ElESCR9PTION £}F WD�tK: ,~ " ,.E� , ,' ; : ° , ; , � ,.__� <br />. .-1 Y �. k:�y ... <br />� <br />+CONTACT INF�RMAT![iN <br />QWNER NAME: TENANT NAME (If Commercial): <br />QW(dER AAAILtNG ADDRESB: s-rae�r <br />CITY STATE ZIP <br />OU1It�Ef2 PNL7NE: OWNER E:MAlL: <br />CONiRACTtJI� N.4hfiE: : z;. . � �: <br />s �_ <br />COP'JTFtp4CT4R A[}D8?ESS: 3TREE7 J�� €' p ��f �� , <br />Cf7Y � �' f � &TATE V�� ..� ZIP <br />cor�-rr�n.crvR p�or�� ' �,;J :���_:� ��� H; _, '� con�-rwarraR �nnaN� �`�, �E � , r � � .� � :.:= <br />CON'iRAGT�t7�F LI���. #(REQLtIRED . - CtTY OF EVEt��TT BUS�I�NESS LlC. #{REQkJ�P.ED}: .�" ��-c E.. .- , <br />PRtMARY GqNTAGT; C! t�WNER t�,C4NTRACTOFt ❑ OTHf:R (Please Specrfy) <br />Cf3M'a,4C3" NAtdiE. Cf}FlTACT PF}ONE_ �_. =� <br />: <br />4 g <br />�'� . � . � CONTAC'f EMA[L: ,,� �� � � , ��� !'' 3 <br />AGREEMENT_ T hereby certify that J have read snd exarriined this application and know the same to be tnae and correct. Att provisians of laws and ordinances governing this <br />type of work wit! be complsfed whether specified herein or nat. The granting of a permit does not presume to give authoriry fo violate o�cance/ fhe provisions of any other stale or <br />!acal !aw r�ula�ing r,�insln�ction or fhe performance of constn�cti�n. That t am authaizr.d by the owner of tt�is properiy to perfarrr� fhe work fo� which appticafion is made and 1 <br />cam�rfy with fhe Sfate Cantiac#ors Law iS.27 FrCW and Zyfi.2L�0 WAC. <br />� � -� <br />� ' <br />DwrrerfAuthorized Agent Signature Date <br />Giy of Everett D�ciaJ Jse Only <br />FEE <br />+��. <br />� � ._ <br />PERMIT # <br />��.�)�°� / <br />E `1�(r� � �,� � , �,` �'� r�� <br />(Revised 7 0/1 212 0 1 5j <br />