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ELECTRICAL PERMIT APPLICATION <br /> J' CITY OF Tt PE MIT SERVICESR <br /> 3200 CEDAR STREET, VERETT,.WA 98201 <br /> (P)425-27-8810 f FAX 42 -267- 67 E re s re 4w - , er . , ov/ ftp <br /> PROJECT ADDRESS: boq ii/th 3,6 R <br /> BUILDING <br /> ,or tion) SF <br /> AREA(it residential,new true ,re <br /> BUILDING TYPE: D,SFR-DETACHED. 1 S R ATTACH C 0 DUPLEX In MULTI.FAIVIILY-#OF UNITS: _ 0 CQMM R IAL <br /> USE OF 81lL ING Pia'1'1 d i . <br /> CC NTNACT PRICE OF WORK: - , <br /> NUMBER OF DEVICES(if low vo > b <br /> FIRE : Its? 0 Yes >NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION-OF WORK: ; •` ` <br /> 1. t �� <br /> O`N TENANT NAME�C*t r r <br /> L <br /> CITY ElAg.kt, w, STATE, L/1. ZIP CIS r 03 <br /> OWNER PFIQNE: OWNER EMAIL... <br /> CONTRACTOR NAME. k{e <br /> CONTRACTOR ADDRESS, sTREeT .. , <br /> ifvc <br /> wA ztp t <br /> ^d 4 '; STAT? <br /> CONTRACTOR PHONE: t F CONTRACTOR EMAIL <br /> CONTRACTOR LIC, ..REQUIRED:E ;, CITY OF EI/ERETT BUSINESS LICK: /REQUIRE% ;. <br /> PRIMARY TACT: 0 OWNER ri CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT N a CONTACT PH0NE: �-31 <br /> • e ✓ • pri CONTACT • L.: j '.e6e ,: r i : v— <br /> 4,4 <br /> AGREEMENT:d hereby certify that I have rad and examines/tib'applicetdora and know the same to be true and oonoct. AI provisions of laws end ortinanoes governing this <br /> c+f work win be completed whether specified herein•r r not. The granting ore petecit does not presume to give authority to violate or cancel the praviaions of any other state or <br /> loom law,,eguiating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which amileatiort is mde ant <br /> comply with the State Contractors Law 1&.27 RC W and 296 2OU WAC. <br /> City of Everett Official Use Only <br /> 4 <br /> PERMIT <br /> E <br /> t hoz , isettC8) <br />