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ELECTRiCAL PERMtT APPL1CATtON <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 982fl1 <br /> {P)425-257-88'f0 � FAX 425-257-8857 ( (E}everetteps@everetiwa.gov( www,everettwa.gov/permits <br /> � . �������`�����.��� .< ��'���` <br /> � r . <br /> PROJECT ADDRESS: _ <br /> _ � <br /> :- . _. <br /> �UILDING.AREA(if resldent�al,new construction,;remodel,or add3tlon} SF <br /> �UILDING TYPE: ❑SFR-DETACHED CI SFR-ATTACHEO ❑DUPLEX ❑MULTI-FAMILY #OF UN1'f°9: ❑COMMERCIAI <br /> , _ <br /> 1���i0F BUILDING.: _ . <br /> � * � tia � ^,��'�t. <br /> x� �.� ' •�€�.::� � .� �,r � <br /> �� ����� �� <br /> �� ... .,a, ., .r � . � , <br /> , , , .� , _.� <br /> CONT.RACT PRtCE OF WORK: $ (� , <br /> _ _ <br /> NUMBER OF DEVICES if low volta �.; <br /> FIRE...ALARM? ❑YES_. <br /> �i��'OCtATED BUILDING PERMIT# Pf a fiC�ble> . <br /> _._.._ <br /> ���TP_"���s��3���.�Rl�:_::..�, . . ; <br /> .. v_ `. ._ � <br /> .� ... f _ <br /> d � ^�'�������� � e� � — .... .. .. <br /> .. .."',.� .. .a . , z. . w ... ". .. . .. ....... <br /> , dWNER NAME: . . TENANT NAME:!f Commercfef;° <br /> OWNEB MAILING ADDRESS: sTR�er <br /> �� <br /> _ �, .. CRY..�:�'L.i� . ,... . . . ��TA"f����. ' � ... �.�ZIP �' . . <br /> ' � . :� ',-- � .. .... <br /> OWNER PHONE: �' � ` t3W�lER EMAIL, a <br /> _ . .,._ __ _ _, <br /> GONTRACTOR NAME: .:: . . <br /> ' � <br /> _ <br /> CONTRACTOR ADQRESS: srReer � , ��j� <br /> .. OITy •' �., .' - . ._ ..., �'. - STATE �: : � .... Zlp �-�" ,. ,' � �.. <br /> � <br /> CONTRACTOR PHONE: �. CONTRACTOR�MqIL: _ ` <br /> �, i�'i'Fd"�4`�'�CS��< , , !1� : : ' ,, <br /> YY� <br /> ,. ::: <br /> PRIMARY CONTACT: ❑pW(�E�� CONTRACTOR �~�� ��OF�����US�NL�LIC �RECiLiIR s <br /> ❑OTHER(Please 5pecify) , _ <br /> 'GONTACT NAME: CQNTACT PHONE: � <br /> � ��� � ' <br /> � <br /> � <br /> _ • : , � ���4�>Ie CONTAC7 EMAIL R� ��� �$�'�'} <br /> : C� ' <br /> AGREEA,�ENT:I hereby eertUy that ;have read and exammed fh/s applicetion and know fha sama fo be trve end eoaect All provlsrons otlaws and ordlnances goveming�his type <br /> ol work wllJ be completed whefher spec/fied herein or noG The granOng ol e permR does not presume to gfve authority ta vtolafe or canceJ fhe pmvls/ons o(any ofher state or <br /> local law regu/ating construction or the peNormartce o/constnicfion. That!am aufharized by fhe owner o�ihls property la perform!he work tor whlch appt/catlon is mada and I <br /> cornply wlfh tha State Conttactors Law 18.27liCW and 296.200 WAC. <br /> C!!y ofEverett Ofl7clal Use Only <br /> � <br /> PERM IT# <br /> .�_ �,�� . � _ E ( �0 2-0� <br /> t�wPr�srla4�t�€e�r��ed Agent�P�#tature r Date ' <br /> lRe�tsed a�z�o�s� <br />