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ECTRICAL PERMIT Al _ICATION <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: 3L-I -a(D $10U, � 2Z) <br /> BUILDING AREA If residential <br /> '---Pew construction, remodel or addition) h�Y18�11�r1 SF <br /> BUILDING TYPE: SFR <br /> �-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: `�1J, I <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑ YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: � � 6 AT— <br /> rS 5 <br /> CONTACT INFORMATION <br /> OWNER NAME: b TENANT NAME(If Commercial): S C' <br /> OWNER MAILING ADDRESS: STREEr'3 LA DO <br /> CITY STATE V4r <br /> OWNER PHONE: �5L—LAIt—uILAo OWNER EMAIL: <br /> CONTRACTOR NAME: RA L! QWOC-4 C, <br /> CONTRACTOR ADDRESS: STREET 53 I -304--- $l% QQ <br /> CITY STATE ZI V <br /> CONTRACTOR PHONE: —Z) CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED) v-1xA pE ij UQ- Lo ICITY OF EVERETT BUSINESS LIC.#(REQUIRED) 3.1 <br /> PRIMARY CONTACT: WNER ❑CONTRACTOR ❑ OTHER (Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE:1-��r/��� <br /> V v r1�/ S CONTACT EMAIL: J � <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 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 /> FEE rl <br /> 4, <br /> i1 PERMIT# <br />