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� . <br /> ELECTRICAL PERMIT APPLICATION <br /> 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 � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: / I �c.� (f�!/`�/��� �J/ <br /> BUILDING AREA(if residential, new construction, remodel, or addition) /�j f�C-� SF <br /> BUILDING TYPE: ❑ SFR-DETACHED LJ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: ),�/1/c.c� rl�Gvl i L� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ �L>J • � <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES G�NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: �f�:2(� �•G�(j '= �f��L`Li/��� <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �-7cG�'f ��(„�� 7/Z I C� <br /> CONTRACTOR ADDRESS: sTREEr �UO� (��L'U�L1 /�Li/� <br /> CITY �(/�LL`/ STATE ZIP 9LT�,� <br /> CONTRACTOR PHONE: yZ`j � j t,��-S�C1 � CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): ��- iZ�! �U�-C��S .�LO CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(J`.D `�Z <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Zl Z,�— j �?- j�v� Q <br /> (�� /[���e t//C-���� CONTACT EMAIL• j "��l(�I �7 g" ���f]C'1• C.r%�� <br /> AGREEMENT.I hereby certify that 1 have read and examined this application and know fhe same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 o�the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> -���� y � z�� E �i�l 0 - ��Z <br /> , <br /> nerlAuthorized Agent Signature D te (Revised 9/23/2016) <br />