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�,E�TRI�a4� �� �IIIT �4P�L1�AT��N <br /> CITY OF EVERETT PERMfT SERV(CES <br /> 3200 CEDAR STREET, EVERE`I-f, WA 98209 <br /> {P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everetfinra.govlpermits <br /> <, , . . ; _... , _ <br /> ._ . .. . <br /> ... <br /> ` PROJEC7'SITE INFORMATI�N', ` <br /> .. .. . _ .. _.. . <br /> �. .. , . . _.._. .. . _ ... . . �. , . . , . <br /> PROJECT ADDRESS: 2 ,I'GG i„d -Q. <br /> BUILDING AREA{if residential,new construction,remodel, or addition) SF � <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OF BUILD[NG: Q,�`/ fjt/qr� N$2� � <br /> , .. ,, _ � <br /> --- <br /> ; ; ELECTRICAL A.PPLICATION INFARMA,TION <br /> CONTRACT PRICE OF WORK:$ �S' � <br /> NUMBER OF DEVICES(ifi low voltage):� <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATEb BU(LDING PERMIT#(if applicable): <br /> DESCR[PTION OF WORK: 2 w SQ✓✓i� �t� � „ � C� �t'�di G /�C S <br /> .. ,. . , :. .. . <br /> . . : ..: . ... . .. . . <br /> .: ,.._ ._ . _ . <br /> _. _. ,: _ <br /> • ,.CONTACT.�INFORIIAATION.._, <br /> OWNER NAME: ,S� � S TENANT NAME(If Cammercial): <br /> OWNER MAILING ADDRESS: srReEr Z�f �'c�V yvo /'T'J{. <br /> CffY (�✓�IC6 STAI'E ZIP <br /> OWNER PNONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ��C ��(', t'. <br /> CONTRACTORADDRESS: slxx�r '� 1' C...�� <br /> cin N✓1"� STATE ziP Z 3 <br /> CONTRACTOR PHONE: 3�vU^�S —Q Z CONTRACTOR EMAIL: R n��» ��h C E ',' i9� <br /> CONTRACTOR LIC.#{REQUIRED): ��'I C EL� G Z 3C CITY OF'EVERETT BUSWESS LIC.#(REQUIRED): V�"j`"I �3 <br /> PRIMARY CONTACT:� ❑OWNERA ' l�'CONTRAGTOR ❑QTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ��G..-�'�j.- � � <br /> ��q y� �f��G CONTACT EMAIL; c��,�� �' E ,e�,�r,�L` <br /> AGREEMENT.•T hereby certify that i have read and examined this appiication and know the same to be true and correct. All provisions of/aws and Drdinances goveming this <br /> type of work wilibe complefed whether specifred herein ornot. The granting of a permit does not presume to give authority to violafe or cancel the provisions of any otherstate or <br /> /oca!law regulating construction or the pertormance of construction. That l am authorized by the owner of this properfy fo perform the work for which application is made and l <br /> comply with the State Contractors Law 98.27 RCW and 296 200 WAC. <br /> City of Everett O�cial Use Only <br /> FEE � <br /> ����A � <br /> PERMIT# J <br /> s��-, � � o��2� <br /> Owner/Aufhorized Agent Signature Date (Revised 90/92/2095) <br />