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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 /> ��� � � £ ` ,..' . ,r�,��'� PROJEiC�l�.SITE INFORMATION .. . . � .,.���,���5���.�.`"����� � � <br /> � ���.h �.� �.�� ���. <br /> _ .� . . , . <br /> _ _�a , ..� _� ..�� . � _.,. .. ..�.�., <br /> PROJECT ADDRESS: ��1�T �Q S 1 S� <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 BUILDING: �� �-, E F y�,�; '� � el� <br /> ' ELECTRICAL APPLICATION INFORMATION '; <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low volta e): <br /> FIRE ALARM? ❑YES �'NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �d.i �J �it K �G,� Ne P � S l� .� <br /> 6�se � � <br /> � ;COI�TACT tNFORMATIO,N , � , v �_�,�k., . . ` <br /> OWNER NAME: L ���/� TENANT NAME(If Commerciaq: <br /> OWNER MAILING ADDRESS: srReeT �i�� �q� Sr 5� <br /> ciTv �V.2f.2f--�- STATE I!J/4— ziP �ISo2O3 <br /> OWNER PHONE: ��S �3S (yOfj OWNER EMAIL: �Q.�(,. �- Crov�L��'v1A-r? � �jYV� <br /> CONTRACTOR NAME: C]I�`��Y` <br /> CONTRACTOR ADDRESS: srReer <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: f�,OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2�' y3j t�,Yd� <br /> �,I�ZL C�tp.F� CONTACTEMAIL: �'�`��• �,e�,e� �M��. . � <br /> AGREEMENT.�I 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 completed 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 1 am authorized by the owner of this property to perform the work for which application is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WqC. <br /> �....._._._ <br /> City of Everett Official Use Only <br /> PERMIT# <br /> __ E I� �'-� � I� <br /> Ow r/ thorized gent Signatur Date (Revised 9/23/2096) <br />