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JAN-05-2016 09:41 ELECTRI-CITY 425 672 6799 P.02 <br /> ELECTRICAL PERMIT APPLICATION <br /> 4*7r CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 E FAX 425-257-8857 1 (E)everettepsgeverettwa.gov I www. e�,Yr <br /> gov/perm its <br /> 6 kic #!,,je` 14r,, OMATlcf <br /> -Z'S <br /> PROJECT ADDRESS: Po f f E) C,-&-ye4l N-n t1-a-L-T-7 f�oae SSG <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> ,BUILDING TYPE: L1 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 11 MULTI-FAMILY-#OF UNITS:— 11 COMMERCIAL <br /> IUSE OF BUILDING: <br /> ;ib'g 11'.. •. <br /> ..... <br /> JR. <br /> T <br /> bAt <br /> _j.......... ....... <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES if low voltage): <br /> FIRE ALARM? 0 YES ONO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: <br /> ON 4;' <br /> 7 F. <br /> OWNER NAME: �-14 A,am TENANT NAME= If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY SYAT9 ZIP <br /> OWNER PHONE: 1OWNER EMAIL: <br /> CONTRACTOR NAME: -oUee-lrl- 42z�- <br /> d <br /> CONTRACTOR ADDRESS: STREET/g�/.;?' �g / <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE,-"2/�§�: 14-(*- Z'F 7 ICONTRACTOR EMAIL: <br /> CONTRACTOR I-IC-#(REQUIRED)����f ICITY OF EVERETT BUSINESS LIC.#(REQUIRED).4�1&r <br /> PRIMARY CONTACT: 0 OWNER V'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> ICONTACT EMAIL; A <br /> AGREEMENT T horeby cortity that I have read and examined this application and know the samG to bo fruo and cotrnl, All pFoylsions of laws and ordinances governing this <br /> type of work will be completed whether speeffied herein or not. The granting of pormit dogs not proSume to give sulhority to violate or cancel the provisions of any othor slatO or <br /> local isw regulating construction or the performance of construction, That I am aulhori7ed by the owner of this property to perform tho work for which applIcallon is made and <br /> comply with the Slate Contractors Law 18.27RCWao0r296.200 WAC. <br /> City of Everett official Use Only <br /> FEE <br /> PERMIT# <br /> EIGOJ - <br /> Ow4r/Authorized Agent Signature Date (Revised 101121201E) <br /> TOTAL P.02 <br />