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LLECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I vwwv.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 0 0 Z2.S I`('.* AQE4 U I^ SE LJ��I A $Ull.Dt Od :& Q <br /> BUILDING AREA(if residential, new construction, remodel, or addition)Com: $ SF RpV6tW—Y SO x 1C0 <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX MULTI-FAMILY-#OF UNITS: to ❑ COMMERCIAL <br /> FUSEOF BUILDING: A�PtI�TFiEIJ'C-5 (Z�Sl��n1"�(Ot�_ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 7oo <br /> NUMBER OF DEVICES (if low voltage): 2 Kc>5-%'AT- C—R eXV-9-Lo2. W Q <br /> FIRE ALARM? ❑YES NO Sl€C�:ts�C.A L- '5,{e-r->/PVI= 1=i=1,(Z 4eArT� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Ay-' : 'l AAA t'cR� 3 S <br /> DESCRIPTION OF WORK: lr4t-: 1�LL- t�toSi 3 +1-4EPFTtIvC� *4,ovut�, AT- <br /> FA,. <br /> T <br /> FA,. (NL-&(Z--r( A--,3SL- L6C-A"SFD Ot--� V—zO2 cs�-= gv t L p (NG <br /> CONTACT INFORMATION <br /> OWNER NAME: F'--Al(-F(E(D VVL= LA-C-TENANT NAME(If Commercial): SAMA — A <br /> OWNER MAILING ADDRESS: STREET jlo O (-('oVS [��1� SJ 1'T -j!lF 2cL> r� <br /> `t CITY Dl�i�O STATE cA ZIP 21 Z <br /> OWNER PHONE: 1J��E OWNER EMAIL: tsoPl <br /> CONTRACTOR NAME: EPl C. CL.�C2(Z �G (►�1G <br /> CONTRACTOR ADDRESS: STREET T•0- ,y�C��/�� (,�75 7 (� Q <br /> CITY J NOS v r� ` STATE Lo A, ZIP �U� 1 <br /> CONTRACTOR PHONE: �3� ��oH— rj9SS CONTRACTOR EMAIL: 2 lGe IeGIL@ C3 ,�b(� <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42r, -34-3-57S-S— <br /> e <br /> 343.-57gSe PJizz".0i-® CONTACT EMAIL: <br /> AGREEMENT:Thereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type 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/am authorized by the owner of this property to perform the work for which application is made and/ <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 4 63* <br /> PERMIT# <br /> ow /Authorized Agent Sig ture Dae (Revised 10/12/2015) <br />