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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 /> , <br /> ��� f �_<������� ",�;���, �� �, PROJECT SITE' INF4JRMA:T 3N����������'' -•`������ <br /> .�� w��x...�?.� �'�.�..� r� ..z:.���:�:�. .�,`��.-�.s�. .,,�»..�..��',�,��-,�.���..�-. �.: �: <br /> PROJECT ADDRESS: ��� 3 ES.L S�T <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 3�g � SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED �UPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: �p�,;j '��,,��� . <br /> �" '_�'S�; "�"��<�`'`��4�`� �'}��'�� "F t ELECTRICAL'z'APPLICATIONS�INFORMA''[IONj� ` ' `� °�' � " , � `'„"'x,�; <br /> ..� .�.. � <br /> CONTRACT PRICE OF WORK: $ ZQ' c�� �`-' <br /> NUMBER OF DEVICES (if low volta e): <br /> FIRE ALARM? ❑YES Q['NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: � a K f,,';�� - <br /> S'� �. - i �E RU <br /> � ��'�`•-� � _ CONTACT INFORMATION `� �� � <br /> OWNER NAME: i�'(C C � (L C.V �1(^�s TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rReer ��f'oZ ��LC� S'( <br /> CITY �V y,�..,.� STATE � ZIP T � �0 <br /> OWNER PHONE: �0�;7 73 � �"j OWNER EMAIL: <br /> CONTRACTOR NAME: M C�� � �(,.�C,(R �°O t'(.? <br /> CONTRACTOR ADDRESS: srReeT 3��5� S O — <br /> CITY ��3:.r�►. � STATE W� ZIP ( � �� <br /> CONTRACTOR PHONE: �{�,5 3 d -d CONTRACTOR EMAIL: (�(C�l�t f - R GM ��-• <br /> CONTRACTOR LIC.#(REQUIRED): �C[�( e,BQ Y.)J CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Q.3 3�C� <br /> PRIMARY CONTACT: ❑OWNER I]�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �f�g 3� .�� � <br /> M((C� 1��C�1(.�� CONTACT EMAIL: �� <br /> AGREEMENT.�l 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 complefed 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 6y the owner of this property to pertorm the work for which application is made and I <br /> comply with the Sfate Contracfors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 8 _�_ f�� E �� �-a3� <br /> O er/Au orized Agent S n re Date (Revised 9/23/2096) <br />