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� • <br /> ELECTRlCIo►L PERMIT APPLICATI{)N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32fl0 CEDAR STREET, EVERETi", WA 982Q1 <br /> (P}425-257-8810 � FA}C 425-257-8857 � (E)everetteps@everettwa.gov( www.everettwa.gov/permits <br /> PROJECT SiTE 1NPORMATICN <br /> PROJECT ADDRESS: � �j 1 � — v�-�,,� <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-A�fACHED ❑DUPLEX ❑MULTi-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE dF BUI�DtNG: �, <br /> CTRICAL ARPL{CATION iNFQRMATION <br /> CONTRACT PRICE OF WORK: �'{� � <br /> NUMBER OF DEVlCES if low vol e): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCtAi'ED BUlLDiNG PERMI7# if a licable : <br /> DESCRIPTION OF WORK: � <br /> � , <br /> e � <br /> CONTACT INFORMATiON <br /> OWNER NAME: ��� ,,o .� F * NANT NAME(if Commerciai): <br /> OWNER AAAILING ADDRESS: srReeT — "� `�'�3. �j �,,,)� • <br /> crrv �} ' srn� zia � <br /> OWNER PHONE: �} - '( "—" �� '1 OWNER EMAIL: <br /> CONTRACTOR NAME: i �[,.� Q Y' � c� -��Q,C-�(d C.- �,�,� <br /> CQNTRACTOR ADDRESS: snzeeT �,`j ( �� <br /> . d <br /> G7Y �'j STATE ZIP <br /> CQfdTRAGTQR PHONE: �j—�J 1 ��� � CONTRACTOR EMAtL: ��t„+±�` +��y�:�-�� �: tr� � <br /> CONTRACTOR LlC.#(REQU�RED): ��CIC,., �v`� �r,�, �Z � CITY 06 EVERETT Bt)SiM11ESS UC.#(REQuiRED): �- � <br /> PRIMARY CONTACT: 0 OWNER CONTRRCTOR �OTHER(Please Specrfy} •. <br /> CONTAGT NAME: CONTACT PHONE: �'_ (,� �'�° <br /> `�JJ�V1�'t� r' ��,��i��_ CONTAGT EMAtL: � v`Y1C�e' < <br /> AGREEMENT:t hereby certi(y that 1 have read and examined ttris applrcation and know fhe same to 4e true and co cf. Ail provisions of Jaws and ordinancBs govaming this fy;oe <br /> of work witl be compteted whether specified herein or not. The gwanfing of a permif does not presume to give authority to viofate ar cance!the provisions of any other state nr <br /> local law�egu�ating construction or the perfomrance of conshuction. That!am aufhonzed by the owner of this property fo perform the work for whrch app(ication is made and 7 <br /> compJy wrfh the State Contractors Law 18:27RCW and 296.2D0 WAC. <br /> � <br /> City of Everett Offrcia!Use Only <br /> i <br /> � PERMIT# <br /> � �,�� _ ; � � � � ��� � E ��� o -- Zc � <br /> O erlAuthoriz n ignature Date (Revised 912320?6J <br />