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�ECTRICAL PERMIT AP�ICATION <br />E-v � CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � w�ww.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: � . Z� .�%,�'G" L� � (^ Inl �- �,��i(�f.-� �,4� ul � � : <br />BUILDING AREA (if residential, new construction,� emodel, or addition) SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: �(COMMERCIAL <br />USE OF BUILDING �' <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES j� <br />ASSOCIATED BUILDING PERMIT # (if a <br />DESCRIPTION OF WORK: �� <br />/�G2 .��ri,� ��'� . <br />�v�, <br />ER NAME: � Yl i-� �� L e <br />ER MAILING ADDRESS: <br />NO <br />�plicable): <br />�� ��.���c.� (Sr_r / /�o��r����. �.�r�,�>y��,�-r�-�2 .5��� <br />�.�c��i�<S � �;� � <br />Z11� ! L'L y• � : /.,�/r�: <br />CONTAGT INFORMATION <br />� �.Uc�4rev� Cc�� <br />STREET l-� � rU I I�'� � l%� <br />CITY T.L'lV>L GL'�L�� <br />TENANT NAME (If Commercia <br />STATE <br />i � � � � �--► � v� <br />�-e <br />}�:� � �� , � .,- � <br />c- <br />Z�P lr�� c� "%�o <br />OWNER PHONE: �OWNER EMAIL: <br />CONTRACTOR NAME: �� l, `�C!+''U �(,�,, ���,�-�j C, LL�� <br />CONTRACTORADDRESS: srReer � � Z2-�j �Z"�{ /g��-- �^-� <br />CITY �(.il�Ci'� LCS STATE ��� ZIP C�r7' �Z{p <br />CONTRACTOR PHONE: G�t�j -�j �i �� ' l:U'�Z � CONTRACTOR EMAIL: �_ S C'�r�(�,� �` �-'� c� �. C:� �� <br />CONTRACTOR LIC. #(REQUIRED): 1'v I� 5S G ,J H CITY OF EVERETT BUSINESS LIC. #(REQUIRED . J� 3� l <br />PRIMARY CONTACT: ❑ OWNER �`CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE:1� 2 S <? �� c_�;�Z � <br />I� �� �-Q� � v�(�L �i �, CONTACT EMAIL: �_ ,j � �Gt-N ��.1 Gr o ( . C .�� 1^^� <br />AGREEMENT.' I hereby certify that 1 have read and examined this appircatron and know the same to be true and correct. All provrsions of laws and ordinances governing this lype <br />of work will be completed whether speci(ied herein or not. The granting of a permrt does nof presume to give authoriiy to violate or cancef the provisions of any other state or <br />loca! 1aw regulating construction or the perlonnance of construction. Thaf I am authorized by the owner of this property to per/orm the wn+k tor which appiication is made and 1 <br />comply with the State Confractors law 1827 RCW and 296200 WAC. <br />City of Everetf Offrcial Use On1y <br />PERMIT # <br />�j�- E 1l�( 2-� 2 2� <br />(Revised 9/23/20�6J <br />