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• <br /> LECTRICAL 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: � L �L, '�/' � "�`r �J-L' -�--� 1J _ � ZO� <br /> BUILDING AREA(if residential, new construction, remodel,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: $ , �C, <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT# if applicable : <br /> DESCRIPTION OF WORK: GLY�✓I / �� ,� 1 'r ' U i ., Z ,� i! <br /> �� Z _ Ct�� c ,� � �L ZO -�r- �;� � i ce 'c vi ��e�r <br /> �� :` � �� , � � ,,r�. <br /> CONTACT INFORMATION <br /> OWNER NAME: 2 2 �C\ . TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReeT �j��`) L � � ' 1 <br /> C��J . � � CITY STATE \ �'� ZIP � /Z��I <br /> OWNER PHONE: rl C'� OWNER EMAIL: '� ;� <br /> CONTRACTOR NAME: ��� - ��;J�� �� �-� � <br /> CONTRACTOR ADDRESS: srREEr ���'7 j � �1 t�� Y- (� <br /> CIN � �J �� STATE I � n ZIP ���-�, <br /> CONTRACTOR PHONE: � � - �'j- ' CONTRACTOR EMAIL: " � (- j ' �� I.Q ` ��i( �'1, � <br /> CONTRACTOR LIC.#(RE4uIRED):s�' '� Z`j��G�ZG> . CITY OF EVERETT BUSINESS LIC.#(RECIUIRE . ��'I�I I �i <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: C _. "'� 1 _^-� �� ;� <br /> �,����� CONTACT EMAIL: '� �� <br /> AGREEMENT.1 hereby certify that 1 have read and examined tliis application and know[he same to be t ue 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 or the performance of constn�cti . at 1 am authorized by the owner of this property to perform the work for which applicafion is made and I <br /> comply with the State Contractors Law 18.27 RCW and 29 .2 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> �/��f� � E ��-o� �- l� �- <br /> Owner/Au 'z nt igna re (Revised 9/23/2016) <br />