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ECTRICAL PERMIT AP�LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C�DAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ,. ;.� . , <br /> _� .. <br /> � ,� �:r� , <br /> ��� s,,� , .,�; <br /> 6�.=� <br /> PROJECT ADDRESS: 3(.32 BRoAi�q <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SSov � SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OF BUILDING: �3 <br /> �� <br /> CONTRACT PRICE OF WORK: $ ��r.s' �— <br /> NUMBER OF DEVICES if low volta e : Z°r <br /> FIRE ALARM? ��YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: ��gTeo�u., t�o+�..�.y�B�L � ,p�/�fLr'� <br /> � �,,. <br /> �� <br /> ;. - � <br /> �b�= ,fs'' � `� <br /> _ :;�,, �� s <br /> OWNER NAME: TENANT NAME(If Commercial): �.)Zp <br /> OWNER MAILING ADDRESS: sraeer <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> . � . <br /> CONTRACTOR NAME: fl3� 1� F/R£ AN� SEGv/L)7 LL,G <br /> CONTRACTOR ADDRESS: s�aee-r Po ;Be�x 3'7 i) <br /> ciTr A2L I I�I GTON STATE kJ+4 ziP 'c�i 8223 <br /> CONTRACTOR PHONE: H25 �-/H lyyS CONTRACTOR EMAIL: S£Ff � BNI?'�ilL.�.Gt�^'� <br /> CONTRACTOR LIC.#(REQUIRED): $H ff R.tI/'�iZK1� CITY OF EVERETT BUSINESS LIC.#(REG2UIRED): vSSl.q"7 <br /> PRIMARY CONTACT: ❑OWNER �8 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: �E�� 3���� CONTACT PHONE: yZ�S gt�� �t�y,r� <br /> CONTACT EMAIL: �'��F�gN�����,�� <br /> AGREEMENT:T 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 goveming this <br /> type of work will be completed whefher spec�ed herein or nof. The granting of a permit does not presume to give authoriry to violate or cance/the provisions of any other state or <br /> local law regulating construction or the peNormance of construction. That I am authorized by the owner of fhis property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett O�cia/Use On/y <br /> FEE � <br /> � �� �_� <br /> t ' <br /> PERMIT, <br /> �,Z� ,8 -d�- � � �1 -,'1 � <br /> er/Authorize Agent Signature Date � O�evise 10/12/2015) <br /> ��: <br /> ���,,,,��-` <br />