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RECTRICAL PERMITAPCCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE TIT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps 9 eve rettwa.gov I www.everettwa.gov/permits <br /> PROJECT SIT E. INFORMATION <br /> PROJECT ADDRESS: u2 <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: <br /> ELECTRI -AL,APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2 <br /> NUMBER OF DEVICES(if low v Ita e): <br /> FIRE ALARM? ❑YES ❑ <br /> ASSOCIATED BUILDING PERM If applicable): <br /> DESCRIPTION OF WORK:/ /p�/, y /c�,' '��y/f ��\^�Y ,� A-_LW <br /> /� / <br /> 1 (►N ��/i v►Y1G1`�a " GYl v"r,d M-)AS 4 kkyyAhj <br /> L,a w� L <br /> CONTACT INFORMATION <br /> OWNER NAME: n� �-f �. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET�[i`C� <br /> CITY �/_ � STAATE��W/�_ ZIP {/ <br /> OWNER PHONE: 5' U"' 43 OWNER EMAIL:SV Sc oTT f:1Ltifi Q G) il. . <br /> CONTRACTOR NAME: (�`(vlr"(, C <br /> CONTRACTOR ADDRESS: STREET Cj3 3 SC <br /> CFFY STATE ZIP <br /> CONTRACTOR PHONE: i1513s {r3� p CONTRACTOR EMAIL: @/Vj:5-/A A 6{/� <br /> CONTRACTOR LIC.#(REQUIRED): �' CITY OF EVERETT BUSINESS LIC.#(REQUIRE • 3� <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: . 3 x-1_a-L9V <br /> CONTACT EMAIL: 4TVAI <br /> AGREEMENT.-Thereby certify that l 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 <br /> PERMIT# <br /> E l9o9 - � � 5 <br />