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�ECTRICAL PERMIT A�ICATION <br /> CITY OF EVERETT PERMIT SERVICES 6/51�" ��g <br /> 3200 CEDAR STREET, EVERETT, WA 98201 JI—/b"�S <br /> (P) 425-257-8810 � FAX a25-257-8857 � (E) everetteps@everetriva gov � vrww everettwa.govlpermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: (c SI I 10 A^ <br /> BUILD�NG AREA bf residential, ne�v consiruction, iemodel, or addition)� Pf! SF <br /> BUILDING TYPE: SFR-DETACHED ❑ SFR-/1TTACHED ❑ DUPLEX ❑ MULTI�FAiJILY-#OF UNITS__ ❑ COM�IERCIAL <br /> USE OF BUILDING: r <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: 5 � ZDD . 00 <br /> NUMBER OF DEVICES (d low volta e): <br /> FIRE ALARM? � YES NO <br /> ASSOCIATED BUILDING PERMIT# pi anplicabie) <br /> DESCRIPTION OF WORK: In S ��I /�CW � i1 2 <br /> u.;.�, •� • - � /1'Ii r <br /> CONTACT INFORMATION <br /> OWNER NAME: GeS e d TENANT NAME(If Commercial�: <br /> OWN[R MAILING ADDRESS: srHte� <br /> 11iV SLAtE <br /> OWNER PHONE: OWNER EMAIL: I e Mcti' rv� <br /> CONTRACTORNAME: �irJ/NcryYr.�a- /: <br /> CONTRACTOR ADDRESS: srr+ee� F O �X I I7i <br /> Cirv �J� SIAi[ .'m Q � Z� � <br /> / O rV' <br /> CONTRACTOR PHONE: O 7O S CONTRACTOR EMAIL: �( <br /> CONTRACTOR UC. #�R[OUIR[D): GO�^'� CG 1'� Sv� CITY OF EVERETT BUSINESS LIC. #(RE�UiREU1: —I $ <br /> PRIMARY CONTACT: O OWNER CONTRACTOR ❑ OlH[R(Please Spec�fy) _ <br /> CONTACT NAME: CONTACT PHONE: �LS �QG <br /> � CONTACT EMAIL: yy�50k�(-�N-d � C � (,�J . Gd M <br /> AGREEG'LNt I Aen:by cert�ry fhat 7 ha�e maC onC exam�ned fhis oppircahon ur.d Anow Ihe same fo De Nre and mnecl Aif mo��s�on;oUaws antl ord�nances 9avem�n9 fne <br /> f ype o/no�N�v.A be Conrp!Cletl w�Clher SpeGlied he�em or nol TAe qn,nhng o�a pe�r,ut tloes��ol F�esurne!o g+ve aufhonty(o v�c�ale or can�e�Ihe O�mii�ons ol any o.'�er slzte or <br /> ioca�ia�v�e9uiahng cons!rud�on or fhe pedo�nance ol conslrudron Thaf I am,iulFon.etl by fhe o�ener o!Ib�s pmp^tl y fo p^rlomt Ihe c+mk!or�r��cb applicahon a n+�de and I <br /> mmpry�cdn�hr Srate Con!i,�ctors La�.v iB 27 RCL'Jand 296700 LVAC <br /> Crty o�Everett Oli�aal U;e Cnly <br /> F[E <br /> ��0 �O/ <br /> � . PERMIT# <br /> ,�� E �i - O��b <br /> mr/ o ized t Signa �c ite (RevrscJ IO�1J207.1 <br />