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" ,ECTRICAL PERMIT APLICATION <br /> CITY OF EVERETT PERMIT S VICES <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 <br /> SITE INFORMATION <br /> PROJECT ADDRESS: 7065 o l � <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF ,,,��^^ <br /> BUILDING TYPE: ElSFR-DETACHED ElSFR-ATTACHED [I DUPLEX ElMULTI-FAMILY-#OF UNITS: L7COMMERCIAL <br /> USE OF BUILDING: c 1� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ G U� <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> _ c <br /> DESCRIPTION OF WORK: ,ryl o� Ste,• �C-G G" �a. �..� �'- Cc��� ��l�L 1.�� lam« <br /> CONTACT INFORMATION <br /> OWNER NAME: !.J<ST6 TENANT NAME(If Commercial): C _S SC-/vacs l <br /> OWNER MAILING ADDRESS: STREET q L C) /ti Or <br /> CITY STATE LLi14— ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: s - l <br /> CONTRACTOR ADDRESS: STREET <br /> CITY / STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: E'l"� Cox, <br /> CONTRACTOR LIC.#(REQUIRED): 9._ a(4 Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED)4� 3 <br /> PRIMARY CONTACT: ❑ OWNER 9-16ONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT.'T 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 <br /> type 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/am authorized by the owner of this property to perform the work for which application is made and/ <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> O r/Authori gent Signature Date (Revised 10/12/2015) <br />