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�ECTRICAL PERMIT AF��ICATION <br /> CITY OF EVERETT PERMIT SERVICES 61SI��16Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /l �-oS��S <br /> (P) 425-257-8810 � FAX 425-257-8857 � (E) everetleps@everethva.gov � www.everetM+a.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRE55: zj O(7 � C � <br /> BUILDING AREA(�t resident�al, new construchon, remodel, or adtld�on) Sf <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACH[D ❑ DUPLEX ❑ MULTI-PA��11LY �ri OF UNITS ❑ COM�dERCIAL <br /> USE OF BUIIDING: � <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: 5 U'O �� <br /> NUMBER OF DEVICES (d low volta e�: <br /> FIRE ALARM? ❑ YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT # (d applicable). <br /> DESCRIPTION OF WORK: ',n 6 � ��-2�— O'� C 6 ✓� <br /> �o.,. :�-- �U'' �G -�B �i—:.,.�. <br /> CONTACT INFORMATION <br /> OWNER NAME: � �C'S� 1"� - �E TENANT NAME pf Commercial�: <br /> OWNER MAILING ADDRESS: sraeer bC�/ 9'✓}Li� P <br /> arv s�niE /T z�n ��� <br /> OWNER PHONE: 4"�25 - 5 �Z -?J�L� � OWNER EMAIL �.Yl �-�}� �-e5 vv�CtlS�'�Yl� <br /> CONTRACTORNAME: �+�V� �f: L <br /> CONTRACTOR AD�RESS: srr+=e; ,�j h L <br /> Qlv � � st�l(: 2m Z70 <br /> GONTRAC70R PHONE: � - _3- CONTRACTOR EMAIL: r . �hfc'v'Ot�2 � • ���/� <br /> CONTRACTOR LIC. N�aE�UiaEDI'�C-��F C^ Z R� CITY OF EVERETT BUSINESS LIC.p�REQUi�t[D): �j3� I -1 <br /> PRIMARY CONTACT: ❑OWNER .ONTRACTOR ❑OTHER IPlcase Speu(y) <br /> CONTACT NAME: CONTACT PHONE: Z _ 23- 8-� `— <br /> CONTACT EMAIL: ,C C � Y�'eT <br /> AGREEA'ENi i heieDy cert,!�V�al��ave�eaU antl e�am���rd I�is app!:cahorr and Fnow Me same fo De frue and conrcl d��pmv�sions 0!law5 and ortlinances govem�ng Ihis <br /> lypr o�ro��m��l�Oe comphlra«I:cfnCr Spco(�ed herein or nJt The granhn9 of a pe�nnf d�Cs no!O�c;ume fo gnu Julhonty(o riol�te or[an[N thc prova�ons ol any olhc�S(JfC o� <br /> �ocai Inc. re�u�afm;��nns!n¢6o�a fhe F"'}�'msnCe o!consln¢lion I�af i am oulhontetl Dy Ihe oc.ne�o�!^.�s p�opCrty to PC�(omilhe worklor�c�ic�appiic3fion i5 made and I <br /> con�ply w�t�t�c 9a(e Cootr;r_tors Law Itl 27 FCIY eny�96 20�INAC <br /> CAy ol Everett ONicral Use Only <br /> FEE <br /> � �Oa�� <br /> PERMIT N <br /> /� , .� E I� - I1�2 <br /> Owner/Aulho �.eA Age ignaWre Dat Incnsed 7(1�1:;7J�`,I <br />