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�ECTRICAL PE�tMIT AP�ICATIt�N <br /> c��� a� �v�R��rr ������ s����c�s <br /> 3200 C�DAR STREET, EVERE7T, WA 98201 <br /> (F')425-257-8�1a ` FAAJ�425-257-ss57 � {E}ever�ttep�a�ieuerettvua.ggv� w�uw.ev�rettw�.govtpermits <br /> �R��1�' S1T'� �M�t�R�A"1"��N : ,: <br /> �+�o��crAoo��ss: 2(�C}1 Rc�Ckefell�r Ave Everett WA 9$�0� <br /> BUILDING Ai�EA{if residentiai, new construction,remode{,or additior�} SF <br /> BUiLDING TYPE; iZ1 5�'R-p�TAGHEO CI S�R�ATTAGMEL� C! DtlPLEX ❑ Ml1L'fl-FAMILY-#{3F U#VITS: CI CC3MMERCIAL <br /> USE OF BUILDING: Restiderttial <br /> - E�.�G7RICl�L APP'���ATiC1N �N�'QFrMAT10N <br /> �c�r�r�zacT�RicE o�wc�a�: � 20�0 <br /> NtJMBER C?F t�EViGES if low vc,lta � : <br /> FlRE ALARM7 f�YES 0 NO <br /> ASSUCiA'CE[}BUILDlNG PERMIT�f if a licable : <br /> DESCR(PTI4N �F WQRfC: 200am panel, New 200amp c�verhead serivice, meter/rnast <br /> ,�_ <br /> G!'�N;'1"ACT I1��C1R1V1ATt�!►1� <br /> CiWNEFr NAME:�t'I�'U �.c'� 7'ENANT NAME If C�mmercial : <br /> OWNEi2 MAILING ADdRESS: s�REer��0� Rockefellar Ave <br /> �,T., Ever�tt S"A7E vYA 9$201 <br /> ZtQ <br /> QWNER PHONE: �O�-4��-�67� OWNER EMAit;Fl�lI0tl�Watlt�J���t71r'31I.Gfltt't <br /> �on�TRacTOR Nann�: Se�Tc�wn Electric Corp. <br /> CONTRAC70R ADdRESS: sT�EE, PU BC}X ��J�S <br /> rfrv ��c'3t��� �p�p <br /> STA7E YYF-\ ZIP �5��� <br /> CON7RACTOR PIiONE: �O�-�OJ-�CgO CONTRACTOR EMAIL: IC1fQ�SE'�tOW11LE�C�t'tC.COt7t <br /> CONTRACTClR I.tC.�(��Quir�Eo}: SEATUEC$60RB CfTY tJF EVEFtETT B4lS1N�SS LIC.#(REt�UiRED}: 'rJ'��'I E <br /> PRIMAi2Y Ct�NTACT: CI C�WNER Cd CC}NTRACTC)R CI t7THER(Please SpecifY? <br /> CONTACT NAME: CUNTACT PNONE: �O�j-�C}�,.�,��0 - <br /> B�'�rtdo�t �'�6�illi�s co��r�cT��Qi�.(�fo seafiown�lectric.cc�m <br /> AGREEd�f�fYT:1 here6y eert/fy fhat f have read anrt examined Chis application anrl know thQ s�rrr�io 6e true ancl�s�rrect q�!pravisions af laws ar�t�prclir��nces gov�arrr/ng fhia tyu�; <br /> r�f work w111 be eanrplate�'wt�atiTer speci�rad taerein or not. 7"hg yrar�fin�of a pen»it daes not pr�sum�fo qrve euthorrty to vrptats or eance!ih�provisrans at any ather state or <br /> loeat 1aw regutating consirucfron or the�erform�nce�of construction. Thai t am authorized by the ow»dr al thrs pro�eriy fo,oer(orm the work for which applicatran is made and! <br /> can�pty wrfh the State Contrac2ors La�78_27 RCW and 296.2Qt?Wr�C. <br /> City af�verett Officiat Use Only <br /> .�.�_. ..��._ <br /> / PERMIT# <br /> ' �--�"� � � � � E L�-o� _ � 1 `� <br /> C3wnerlAuthoriaed Agenf Signature Oat� (Revised 9I2.4i201 fi) <br />