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����`f��l��l� ��� S`�' � '�������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI-f, WA 98201 <br /> (P)A�25-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> I�ROJEC`i' S17'� INFAISQViA`f IAN <br /> _. __ <br /> PROJECT ADDRESS: � � ��✓ ��V� �"� <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: �j�`/��� �� <br /> ELECTRICAL APPLICATION INFORMA710N <br /> CONTRACT PRICE OF WORK: $ � SU <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: '�{� ��l I �`�1�I�I i✓li1r� J�t �/� i'�j ���//�' <br /> _ _ _ <br /> _ _ _ <br /> CONTACT 7NFORMATION <br /> _, _ _ . . <br /> _. <br /> OWNER NAME: i"'�'k� �+•e� ` (�� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s�eEr � � �, ��'�'� 1�'�� <br /> CI7Y � ��� STATE ZIP V'v <br /> OWNER PHONE: N �� ! -�� l KI OWNER EMAIL: <br /> _. . . _..... � / <br /> _. .. .. . . . . ...:... .. . . . .. <br /> . _. . _.. . .. .. ._ <br /> CONTRACTOR NAME: � I�/ �'Vv � �� <br /> CONTRACTOR ADDRESS: srREEr J�JG2/�� s� <br /> ��n � � � �,r-��l� STATE ���- Z�P �' �� a� <br /> CONTRACTOR PHONE: ('J� "�(� — CONTRACTOR EMAIL: �� �(�,1� ��W� ��✓�,+ L G✓�V <br /> CONTRACTOR LIC.#(RE4UIRED): �—�-��dV� , � / �- CITY OF EVERETT BUSWESS LIC.#(REC2UIRED):(QS� 77�5 <br /> _. ._-_....__._. ,. ._._._ .. _ ..._ ...._._ ... ... .......... . _.,.....� .�..... . � . ...._ _..,......... ,.,. ._ __. .. .._..._ ...,.._ .�.,r._..._.�.. . ._:...,.�_._ .,. . .......�. .___.. <br /> PRIMARY CONTACT: ❑OWNER I�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �� s` `-'1���'..��ji�7 I <br /> ��'�,,� �G,�!„��1� CONTACT EMAIL:�f.' ��.�.I I►'1 t'j/�j ' G i7?�•G Ol� <br /> AGREEMENT. T hereby certify t at/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> fype of work will be completed whether specifred herein or not The granting of a permit does not presume to give authority to violate or cance!the provisions of any other state or <br /> local law regulating construction or fhe performance of construction. Thaf!am authorized by tAe owner of this property to perform the work for which application is made and l <br /> comply with the State Contracfors Law 98.27 RCW and 296200 WNC. <br /> Cify of Everett Official Use Only <br /> FEE <br /> � �-S � <br /> , PERMIT# <br /> � � � -�� -��/ � E ��-02� - � � � <br /> 7 <br /> Owne Authorize en afure Date (Revised 10/12/2015) <br /> � � <br /> � <br /> �_ <br />