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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, INA 9£320'1 <br /> (P) 425-25/-€810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I wNna.eve rettwa,gov/perill its <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 7Zn)10 �W <br /> BUILDING AREA(if residential, now construction,remodel,or addition)__!4LA_ _ SF <br /> Bl11LDIN0. TYPE: n SFRR=DDETACHED ❑SFR-ATTACHED_❑ DUPLEX—C)MULTIFAMILY-fl OF UNITS: XCOMMERCIAt_ <br /> USEOF IBUILDING: (�(�e(^ enC� cj �Ca (-et e ( --- -- - <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage)_^ <br /> FIRE At-ARM? Ll YES – MiNo <br /> ASSOCIATED BUILDING PERMIT#(if applicabley N/A <br /> DESCRIPTION OF WORK: _���/e—L �C2 <br /> Cab �eL C) arr)t <br /> CONTACT INFORMATION <br /> OWNER NAME: �(�p�bC(1_>t ��l,Cxa(���� _ TENANT NAME(If Commercial). (\Q�QmL"k") Couniy [bC <br /> OWNER MAILING ADDRESS: STREET b �0cK ���2 m�5 f{()t`� <br /> — cnv J CS - ! SIATI_WA zIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:—C(ways Delaware {nr- -- — - — <br /> CONTRACTORADDRESS: STRLE) y 323 32� 5�_C ++ p� <br /> —_- COY STATL `lam if"/� (�ZIP o <br /> CONTRACTOR PHONE: D0a�; CONTRACTOR EMAIL: ' <br /> CONTRACTOR LIC.#(R[QUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER Vq CONTRACTOR ❑OTHER(Please Specify)__ _ <br /> CONTACT NAME: `- e C ce-oce. F 1 Ot(1Q�(),�l CONTACT PHONE: <br /> CONTACT EMAIL: �E'f(+°(ICC.F+Q Q Ca S.COM <br /> AGREEMEW 1.•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 pemill does not presume to give authority to violate or cancel the provisions of any other state or <br /> local!aw regtrlaling construction or the performance o1 constrrctial. That t am authorized by the owner of this properly to perform the work for which application is made and <br /> comply with file State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FFE <br /> %yy PERMIT 11 <br /> Owner/Author e�i�� glaaluro Date (Revised 10/12/2015) <br />