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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: � � �. ��s— S �— - <br /> BUILDING AREA(if residential, new construction, remodel, or addition) f�����1� �� SF �� .SC�3 [= ) • <br /> BUILDING TYPE: ❑ SFR-DETACHED C�'SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: - `"` <br /> ELECTRICAL PPLICATION INFORMATION <br /> CONTRACT PRICE OF WO : $ .�d Q(� — `� <br /> NUMBER OF DEVICES (if I voltage): .-�`f <br /> FIRE ALARM? ❑YES ------�'�NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: /�' �S�C? `z � • �P� �Cd�� � cS �� � % �f C II^LC�. <br /> � arr� l c(� �� �. <br /> CONTACT INFORMATION <br /> OWNER NAME: �/l/l L- �� S 7i✓1� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReeT `" /� ��S P" [-. S � <br /> CITY � /�-�J��� � � STATE �/ \ ZIP C(��O 7 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Q(���� C=�-�=L Z� �C- <br /> CONTRACTOR ADDRESS: srREET ��3 ���� S • ��- �— - <br /> CITY �/ rv�V L(i�� STATE ��� ZIP ��� � `-" <br /> CONTRACTOR PHONE:�ZS S7 -.5 � 2 CONTRACTOR EMAIL• <br /> CONTRACTOR LIC.#(REQUIRED): �C'LLT�'�.L.'�q� �Q j CITY OF EVERETT BUSWESS LIC.#(REQUIR �: 36`i ! <br /> PRIMARY CONTACT: ❑OWNER .�CONTRACTOR THER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: S"� _ � <br /> Zj� � �j ��� CONTACT EMAIL: <br /> AGREEMEN :1 hereby certify that 1 have read and examined this application and know the 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 or the performance of construction. That I am authorized by the owner of this property to pertorm the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 W,4C. <br /> City of Everett Official Use Only <br /> _� <br /> PERMIT# <br /> �. <br /> �-_-_ � �� o �� �.�T _ E � �� �O <br /> dAgent: � at Date (Revrsed 9/23/2016) <br />