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• • <br /> ELECTRICAL PERMIT APPLICATION <br /> O!F77- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 ( (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: e\rt f,�- ,N S YS ej T-T - i oAr C 3 ?, <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 13 MULTI-FAMILY-#OF UNITS: OMMERCiAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? O YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: -A U_ EcsQ E4it `7` oea't <br /> �`"� �.�..._ �� lac��� �� }-v}t�"I�G �c�:,✓�. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME if Commercial): S?1 Q tit,,. [,O tUIEST k <br /> OWNER MAILING ADDRESS: STREET 64b i.4 82-63 <br /> CRY STATE ZIP <br /> OWNER PHONE: O,J--S~ 'C OWNER EMAIL: <br /> CONTRACTOR NAME: CQN 01..70:ati c__ <br /> CONTRACTOR ADDRESS: STREET i5 p� e-c-TOIL <br /> CITY tw k-r Tc STATE lr'*.1 tom` ZIP t e <br /> CONTRACTOR PHONE: <br /> �J -7C3 W CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED) GCS;r�k101 3 CITY OF EVERETT BUSINESS LIC.#(REQUIREd <br /> PRIMARY CONTACT: ❑OWNER $a-CONTRACTOR O OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 9-ce. 763 C 5 <br /> 4'ki �a t t ts� t CONTACT EMAIL' cS ,.``S Vet iW 4 e je_ P� L .t vl, <br /> AGREEMENT:1 hereby certify that i have read and examined this application and know the some to be true and correct. All provis"ns of laws and ordinances goveming this type <br /> of work wilt 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 taw 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 i <br /> comply with the State Contractors taw 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 0.)9— 6 S!E5 <br /> Owne5pltl Date (Revised 912312016) <br /> c_ <br />