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• • <br /> 14ETT ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I vwvw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 7.11-74 I-1p /hie <br /> BUILDING AREA(if residential, new constructio remod- or addition SF 3r^i10 e , 1 p Zj D L/O <br /> BUILDING TYPE: 0 SFR-DETACHED SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: LJ COMMERCIAL <br /> USE OF BUILDING: <br /> 7 l�i�r(P �� <br /> ELECTRICAL APPLICATION INFORMATION <br /> /CONTRACT PRICE OF WORK: $ /5, d 0 o <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): �.�, <br /> DESCRIPTION OF WORK: P {il7+" �Xt�)/-p'J6- / �' ¢' (A)'�1L 1J A) 4-ohir► aAl <br /> Ueliv 0�t `%?tv L 51:41 i <br /> o�tn� CONTACT INFORMATION <br /> 6044,44A) <br /> � 44 <br /> OWNER NAME: C , u TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3313 L r� A-r <br /> CITY � <br /> y '�� ii STATE <br /> ZIP ,Y,:,-7€2 <br /> OWNER PHONE: 6 OWNER EMAIL: <br /> CONTRACTOR NAME: VOW W 6.4 S-2.1Grl21IC. <br /> CONTRACTOR ADDRESS: STREET 4.11/ f 77: cr.. M! <br /> CITY y�7 / iLO((!! t-..STATE 4- ZIP / <br /> CONTRACTOR PHONE: qac(15 j= 5 c7 3'/ �� CONTRACTOR EMAIL: A/„�� 74e./C_-ct--/G /Lr cp,4_ <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O9 go?Y_S <br /> PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: qd.5 <br /> eCONTACT EMAIL: > <br /> AGREEMENT:I hereby certify that I 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 perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> .7 E0� -00(.0 <br /> 1/L. .7 <br /> Owner/Authorized Age ignature Date (Revised 9/23/2016) <br />