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fl. <br /> �LECTRICAL PERMIT A�LICATION <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 /> , ., _, <br /> .. :_. . _..: . ... _ . <br /> .. .._ . . . <br /> = PROJECT SITE INFORMATION: <br /> PROJECT ADDRESS: � �"� S� � I _ �ZC7 . -�,_ <br /> BUILDING AREA(ff residential,new construction,remodel,or addition) SF ' <br /> BUILbING TYPE: ❑SFR-DETACHED ❑SFR-A7TACHED C7 DUPLEX �MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: f f(, � (.l{�1 �-, <br /> ;. .>.; . <br /> .. �_ <br /> .:- ,. .... _ . <br /> ,. ..: . ,.. .. <br /> ELECTRICAL APPLICATION I,NFORMATION � <br /> <:.� . . .. .. .. . ..: .. . . . �, > .. . <br /> . _. . _. .. . ..: , <br /> CONTRACT PRICE OF WORK:$ . <br /> NUMBER OF DEVICES(if low volfage :� <br /> FIRE ALARM? ❑YES ❑NO - <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTlON:OF WORK: C.,L b�1 .�s�7� �t � '�- <br /> , . .: . <br /> _. <br /> ` ,CONTACT INFORNIATION <br /> ._ _ . .. . ,.... ;.. : <br /> OWNER NAME: ��(�y�G ' TENANT NAME pf Commercial)• ( <br /> OWNER MAILING ADDRESS: srneEr�� -���.� C� <br /> CITY STATE'l/�J� ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> ., .. , ...... . .. .... . . . ... . .. . .. ... . . . ....... . . . .. <br /> CONTRACTORNAME: ��[r "r(I�) VLC.LS <br /> CONTRACTOR ADDRESS: Z ��J � �V�' � <br /> . �. . w CIiD������ l�"'�S � STATE W � � <br /> ZIP <br /> CONTRACTOR PHONE: Ck2��Z,�U,`-S Z CONTRACTOR EMAIL: � �►tJ .`3 Z'� +L� � � �y� <br /> CONTRACTOR LIC.#(REQUIRED): ��c � c� �1/�,3 C1TY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNERA ONIRACTOR LD OTHER(Please �' <br /> Specify) <br /> CONTACT NAME: CONTACT PHONE: ��Z���Z2� � <br /> J C��I,— N��C(� CONTACT EMAIL; sC�J (o3.ZS � �451�1 � G�,W�� <br /> AGREEMENT.�T hereby certily that!have read and examined this application and know the same to be true and correct. AI/provisions of laws and otdinances governing this <br /> type of work will be complefed whether spec�ed herein or not. The granting of a permit does not presume to give authorityto viofafe or cancet the provisions of any otherstate or <br /> local law regulating consfruction or fhe pedormance of construction. That!am authorized by the owner of this propedy to perform the work for which application is made and I <br /> comp/y wifh the State Contractors Law 98.27 RCVV and 296 200 WqC. <br /> City of Everett Official Use Only <br /> • FEE <br /> � s � . so <br /> PERMIT# <br /> `----�..�_ �- t� -�,� E �(� � 2 - Oq �-( <br /> Owner/Au�hor' dA ntSignature Date (Revisedl0/92/2015) <br />