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.LECTRICAL PERMIT APPICATION <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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: PGf <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ �QO� <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: i ,• (�, -hi, ' <br /> J <br /> � <br /> 1 ;^ <br /> / CONTACT INFORMATION <br /> OWNER NAME: C�Fif�lCf 5 1 n TENANT NAME(If Commercial): <br /> � q <br /> OWNER MAILING ADDRESS: STREET LG <br /> CITY �{ (� STATE liW ZIP <br /> OWNER PHONE: 2�� 71.6 — CSI 1. OWNER EMAIL: <br /> CONTRACTOR NAME: SOUND SPECIALIZED SERVICES INC <br /> CONTRACTOR ADDRESS: STREET 12433 RUGGS LAKE ROAD <br /> ,, EVERETT STATE WA Z,p 98208 <br /> CONTRACTOR PHONE: 206-427-3455 CONTRACTOR EMAIL: DAVE.W@SOUNDSSINC.COM <br /> CONTRACTOR LIC.#(REQUIRED): SOUNDSS876J9 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 52341 <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-427-3455 <br /> DAVE WAITE CONTACT EMAIL: <br /> AGREEMENT.I 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 type <br /> 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 /> PERMIT# <br /> erlAu r' d Ag Intgnature Date (Revised 9/23/2016) <br />