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10/20/2016 THU 15: 45 FAX 425 252 1666 CM Heating IL002/005 <br /> EtWECTRICAL PERMIT APPICATION <br /> OLCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 (F_) everettepa@everettwa.gov www.everettwa.gov/permits <br /> ''.i,+'�s���r,I,�F�,.�t'v,td•,'{r,;x�dh".i '�"I,�(p',1FI,i fr;.l"',,. r .,F -rr.{, . <br /> „'ir,i.f:{�;r'.itf;,. ';I ;•J'_ %.,",��iY .r:i is Y '.'J.�.,';:r7" : � r ';' ''QI'� •�.. <br /> PROJECT ADDRESS; <br /> BUILDING AREA(if residential, new constructlon, remodel,or addltion) SF <br /> BUILDING TYPE; SFR-DETACHED Q SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF lJNI7S: C1 COMMERCIAL <br /> USE OF BUILDING: <br /> fI'!I>g(f;!�r�k✓�'1}';f:tV: .u•r 3r .'I4 .t �:� ,' <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES If low volts ® : <br /> FIRE ALARM? Q YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#Qf a llcable : <br /> DESCRIPTION OF WORK, <br /> ;t';�� r•"t� °y�'"YY..yliAf',.ti ;�'; .;�;'riir( r,'^�,,",*, I:,a,.,:a „ r .• , , <br /> ,/ 'Sqi1 I�..' a. ':pR ifk.i r) ,4 ;4I' .v � „� �• f <br /> ,L ti <br /> OWNER NAME: TENANT NAME if Commerclel : <br /> OWNER MAILING ADDRESS; sTRE�T <br /> CITY STATE <br /> OWNER PHONE; r �� OWNER EMAIL; <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY rA STATEZIP <br /> r <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL; rn <br /> GONTRACTOR LIC,*REQUIRED : CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT; ❑ OWNER CONTRACTOR Q OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: LfQ5 —� <br /> CONTACT EMAIL: <br /> AGREEMENT;T hereby certify that f have read and examined!h!9 application and know the#erne io be true and correct. All provisions of laws and or'd ncos governing this <br /> type of work wilt be completed whether sp®ollled herein or not. The granting of a permit dogs not presume to give authority to violate or cancel the provisions of any othnr'state or <br /> local law regulating oonstrucrion or the performance of construction, That I em authorfxed by the owner of this property to perform the work for which application Is made and I <br /> comply with the State Contractors Lew 18.$7 RCW and 280.200 WAC. <br /> Clly of Everett Officlal Use Only <br /> FEE <br /> i <br /> eA S <br /> r PERMIT# <br /> Owner/Authorized Apenl 818natur0 pate (Revised 10/1212018) <br />