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4477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: )0/`/ / " , , &-'14%,),i;7 71 iiv'-' . '?` 's-'-1% f <br /> BUILDING AREA(if residential, new construction, emodel or addition) c(`'dCJ SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS,_ 1 1 COMMERCIAL <br /> USE OF BUILDING: (9cczf ,..,-,,,4::,,,;.- <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES LI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): /{//ft <br /> DESCRIPTION OF WORK: ,ZyS-71ZG Z.-. G&W v VOL 7I DfL'Z6 5 Foil c°7Un il/e4/ <br /> C'v/l/0,7-17,g .10 d,/M7Fir f, £d zC F, P6L7,-- Cf 71// SS A CF C,i4'? X . <br /> 77.:r74vf Z 1'V <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): 5 ,4f-e-,7,(4 (--41/24%4 -.4:-.C//,- <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: S' .,1LUM <br /> CONTRACTOR ADDRESS: STREET /G//,,, E!/40L>77 �Jde. set,7TY `0202 <br /> CITY 4/$t/7 7'7 STATE 14/./1 ZIP �, <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: %St.),/hv i✓LL".114,-5-Ale-"z.4/-CUA//? <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(� 5J G S 5 <br /> PRIMARY CONTACT: 0 OWNER la CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: li s- 7.r93_ co Y <br /> CONTACT EMAIL: e-,-',--,.. <br /> AGREEMENT: T hereby certify that I have read and examined this application and know the 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 authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE hh <br /> ✓ C vv <br /> PERMIT# <br /> 7 7 / E l �� 7t g <br /> Owr utho zed Signature Date (Revised 10/12/2015) <br />