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��ECTRICAL PERMIT AF��ICATION <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 ADDRESS: � ��� , S/�'7� �� -�"�= . <br /> BUILDING AREA(if residential, new construction, remodel,or addition) Z���% SF <br /> BUILDING TYPE: • SFR-DETACHED • SFR-ATfACHED • DUPLEX • MULTI-FAMILY-#OF UNITS: • OMMERCIAL <br /> USE OF BUILDING: �%%�fC� <br /> CONTRACT PRICE OF WORK: $ �Z_5Z�' <br /> NUMBER OF DEVICES (if low volta e : I - <br /> _;, <br /> FIRE ALARM? • YES • NO ; <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: /�S%%J/ /E C'�T� �c��/ac,i�L il;'v-'7ZL-'<=�':IL <br /> ;.�G'.�=�' .� <br /> OWNER NAME: TENANT NAME(If Commercialj: >1�JIb' Z�"�.�'�'���L�L Si,'.;';��- <br /> OWNER MAILING ADDRESS: snzeeT <br /> CffY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �'�E C�4-:�i.-L. <C��S <br /> CONTRACTORADDRESS: sTReeT �J � ��L����c'i�'�� �'`v•= -���� <br /> CRY S�'9l� STA7E !✓V��T Z�P C�'-�� �� <br /> CONTRACTOR PHONE: ��5� 7yfJ ��5�'� CONTRACTOR EMAIL: �S��Y�'���� �'`�''�'F���r— ' Cc'�''�1 <br /> CONTRACTOR LIC.#(REQUIRED): �� C.3�'���F�"' �4'��''�� CITY OF EVERETT BUSINESS UC.#(REQUIRED): ��� �5 <br /> PRIMARY CONTACT: • OWNER • CONTRACTOR '� • OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �ZS' ��t� �J(ej 3 <br /> �!'��� ���t3�1,��}H/�f�j CONTACT EMAIL: iQ�j/G���:,C',����-�ti%1'}p�iYl�-Il...� Ct.:l`b'� <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and conect. All provisrons of laws and ortiinances goveming thrs <br /> type of work wiil be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions oPany other state or <br /> local la w regulabng construc6on o�the performance of construction. That I am authorized by the owner of this properry to perform the Kork for which application is made and I <br /> compty with the State Contracfois Law 18.27 RCW and 296.200 WAC. <br /> City of Eve2tt Official Use Only <br /> FEE <br /> � <br /> � �D� �'O- <br /> , <br /> PERMIT# <br /> _�!r . � ! I 1 �,I)VI V � I Vl'�/� ��1 v , <br /> OwnerlA or¢ed Agent Signatu Date (Revised 10/1?12015) <br />