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• <br /> "PLECTRICAL PERMIT APPLICATION <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: `�� Gi <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF ^ <br /> BUILDING TYPE: SFR-DETACHED ❑ SF -ATTACHED 11DUPLEX MULTI-FAMILY-#OF UNITS: 2 A COMMERCIAL <br /> USE OF BUILDING: C'•c1✓�VVZ-1'Y', <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: y � S C., v <br /> �i G�l, LIC-AV <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: r l OWNER EMAIL: <br /> CONTRACTOR NAME: `C N CC- Co VIP <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP l <br /> CONTRACTOR PHONE: -��'3 4)-'-�6(36 CONTRA OR EMAIL: ac(6yl'e-C,. <br /> CONTRACTOR LIC.#(REQUIRED): � �G C ' �i bI'� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> ���� CONTACT EMAIL: <br /> AGREEMENT. Thereby certify that/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 /> c5ga <br /> PERMIT# <br /> E 5 ( wo --49+ <br /> Owner/Authorize ent Signature Date (Revised 10/12/2015) <br />