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ELECTRICAL PERMIT APPLICATION <br /> 32 OI CEDAR STREET, EV RIETT, WA 8201 � �R�GINAL <br /> (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov� www.everettwa.gov/permits <br /> ���' ��� _ �, � � � u � �,� �, �, � � �, , <br /> , � �� � � � � , . <br /> „ <br /> < , � �'� � � ��'"� � �„�� � � ���� �d � <br /> _ � �_ �� <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential,new construction,remodel,or addition) � SF <br /> BUILDING TYPE:�FR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: <br /> �. � � -� -�•-��. =� ��- <br /> �`�� � �� � ��_� �_�� -�E� C'�R C �1P � .QA'�' 1� tlRM � ON�r o � � . ��.. <br /> w a+a-.... �'+.,xSf� ��.C�. u� .E ,.� .a��i rW'i+�u a�t«r�:�.az�d �aH(i�it �t uNt'w�in r��ii 4��;iin��ua��.�a���.�:�r�H. ��,6� .. ;�b reb �k���'. �;.. <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: ` �� - <br /> t�a�{inwre",�,w 6�iqgii�l'� � L�'�E ii �y, — 4 � i i ,i ;n�Gio �-�,n,:��+s.:. wtim ��+�- � r - i •r� iBp �-:ry'�,� : i i p �s.ar h�� � <br /> � i � ��(H i �� `�'' tu x�"'�.N�pi i Y�i 4IHI, �i � ' '�'I 16�'' �,,;I �,.���w I�5r i a (I 1�(2��P�E'��', aq� <br /> » <br /> ���y� i, � �h %�� � '�'�,, Flith -������„r�r '���� �' I tlH�"�'��i�t { '� ' y�"���_t�� s��tiN��' ��� p�dl: <br /> , � �,�a s ti <br /> ,'rs 'a_ .- .a.1-._ 5. ° .Y;=s�'� �^.,_��_. a �>'.� �rP.�.'.w:�+5�= _` e �.;�'` . ��19hx e�e'"�t..-' _.��� "i . t..'a'�°� <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET �j � <br /> cirr �j STAT ziP � <br /> OWNER PHONE: '" C��- OWNER EMAIL: � J <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: � '" �- C CONTRACTOR EMAIL: � <br /> CONTRACTOR LIC.#(REQUIRED): `� 8 � CITY OF EVERETT BUSINESS LIC.#(REQUIRED): , <br /> ���,u _ �� .. _ ._-_ ��� .���� �._� ��� m�.����m._. .._� .�._m_�.�. � e� <br /> ����. t�_ t <br /> PRIMARY CONTACT: ❑OWNER �ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �— <br /> �'���� � CONTACT EMAIL: '� � <br /> AGREEMENT.•T hereby certify that l e read an xamined 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 whethe�specified herein or not. The granting of a permit does not presume to give authoriry to vio/ate or cancel the piovisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which applicafion is made and I <br /> comp/y with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> CRy of Everett Official Use Only <br /> FEE <br /> �� <br /> � <br /> PERMIT# <br /> 2� 1 E � 0 � ( � <br /> Owner A oriz d Agent Signat Date (Revised 10/12/2015) <br />