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��� <br /> LECTRICAL PERMIT APPLICATl4N <br /> C1TY OF EVERETT PERM)T SERVICES <br /> 3200 CEDAR�STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425 257-8857 � (E)everetteps@everettwa.gov� www.everetfinra.gov/permits <br /> . - � ..._ .. <br /> _. . <br /> ,... <br /> , . . <br /> PROJECT SITE INFORMATION'` ` <br /> _ ... : <br /> ,. - ... ,. -_ . ..._ <br /> PROJECT ADDRESS: �'�' s� � . ` �� �� <br /> BUILDING AREA(if residenSai,new cons#naction,remodel,or addition) SF � <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATfACHED ❑DUPLEX I�MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: �f(„ .,� t,,�l '� <br /> '' " ' �� - . <br /> . .: .. ... ... ... , . ... . <br /> ; , ELECTRICAL APPLICATION INFORMAT'ION . <br /> . .... ,. ,. . , , , . . .. <br /> .. _�, , ..-: .. : : . . <br /> CONTRACT PRICE OF WORK:$ � . <br /> NUMBER OF DEVICES(if low voltage :> <br /> FIRE ALARM? ❑YES ❑NO - <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION.OF WORK: G� b� ,�5�� �� � ..r, <br /> , , <br /> . _ <br /> , <br /> :. ., - ..: .. <br /> , . _...: . . .. _ <br /> . CONTACT INFORNIATION . <br /> _ .... <br /> OWNER NAME: �N1��G ' TENANT NAME()f Commercial): � <br /> OWNER MAILING ADDRESS: srneEr�(� -���.'�/� C� <br /> ' Cm STATE'vll� ZJP <br /> OWNER PHONE: OWNER EMAIL: <br /> .. . ...... .. ., .... . . . w . .. . .. ... . . . ...... .. <br /> CONTRACTO,RNAME; �pc[� "'�' !�) VLC.LS <br /> CONTRACTOR ADDRESS: ���� � �v� � <br /> e o;�/acv���. rtitS �t STAr�` W -' <br /> ZIP <br /> CONTRACTOR PHONE: �2��2,1 C.�.�-SZ CONTRACTOR EMAIL: -, Lt-� .4�Z.� e,�� ��,.� <br /> CONTRACTOR LIC,#(REC2UIRED): � � � c�p �l/l,3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�j <br /> PRIMARY CONTACT: ❑OWNER~ ONTRACTOR 4C7 OTNE V ��,�„Yk2�� _ _ <br /> R{Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ��Z��S Z,Z� <br /> ,:� c��(. NE�L CONTACTEMAIL: sf�J (o3ZS @ �sl�) � G��, <br /> AGREEMENT.�T hereby certify thatY have read and examined this application and know the same to be true and conect. All provisions of laws and o�dinances goveming this <br /> type of work will be completed whether specifed herein o�not. The gran6ng of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regu/ating construction or the performance of construction. Thaf l am aufhorized by the owner of this property to perform the work for which applicafion is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Officia/Use On/y <br /> • FEE <br /> � � ` ✓� <br /> PERMIT# <br /> -�...,..,__ �_ ,� --�,.� E 1 c�c 2, — o� 2� <br /> Owner/Au�hor' d A nt Signature Date (Revised 10/12/2095) <br />