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��. <br /> �LECTRICAL PERMIT APALICATION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR�STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425 257-8857 � (E)everetteps�a everettwa.gov� www.everettwa.gov/permits <br /> . : ._. .,. <br /> ,. ,.. . <br /> ... , .... <br /> ' PROJECT SITE INFORMA.TION ' -:': ` <br /> . -. : <br /> , .. :, __ . .,_ _ . <br /> PROJECT ADDRESS: � ��" $� � _ ` g�� <br /> BUILDING AREA{ff residential,new construction,remodel,or addition) SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX IaMULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: (f�, .,f µl j� <br /> . <br /> ELECTRICAL APPLICATION INFORMATION � <br /> . . .. ,.... .. ,.: ,:. , .. . . . <br /> . . _ �. . .. . <br /> CONTRACT PRICE OF WORK:$ C� . <br /> NUMBER OF DEVICES(if low volfage :� <br /> FIRE ALARM? ❑YES ❑NO - <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION.OF WORK: C,lt b�1 ,asry�7l� �„� � ..t, <br /> -: . . <br /> ._. : <br /> _ ` CONTACT INFORMATION. . <br /> ;- . <br /> -:... ; :.. <br /> OWNER NAME: ����G ' TENANT NAME{!f Commercialj: ( <br /> OWNER MAILING ADDRESS: srREEr�� -���.-� S <br /> � ��, �A-� w� �P <br /> OWNER PHONE: OWNER EMAIL: <br /> .. ... . ...... . ., ..... . . . .., . ,. ,. ,. ... . . ,..... <br /> • , . . . .. .. . ... . .. . .. .. . . _.. ..�. .. .. :.. .,. <br /> CONTRACTORNAME: ��rL "'�"(l�) � V�,G�S <br /> CONTRACTOR ADDRESS: � �� � �V�' �� <br /> . � .s CI➢7�"cV����� 1""�,S � � STATE W ^ <br /> ZIP <br /> CONTRACTOR PHONE: Ck.Z�-Z,�L��-S Z, CONTRACTOR EMAIL: -S �f-� .4�Z.� �+,�� � �.� <br /> CONTRACTOR LIC.#(REQUIRED): '• � c�p `U1,3 C17'Y OF EVERETT BUSINESS LIC.#(REQUIRED). �, <br /> PRIMARY CONTACT: �p OWNER �ONTRACTOR ❑OTHE y w�W y..TKYu _ _ __ _ _ <br /> R(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ��Z��_�Z,Z� • <br /> � C�L�L N��j� CONTACT EMAIL: .SGN �o`jZ.S �. �51�! j Go'V,/�, <br /> AGREEMENT.•T he�eby cedify that!have read and examined this application and know the same fo be true and correct. AlI provisions of laws and ordinances goveming this <br /> type of worlc will be completed whether specified herein or not. The granting of a permif does not presume to give aufhority to violate or cancel the provisions of any other state or <br /> loca/law regulating construcfion or the performance of construction. That l am aufhorized by the owner of this property to perform the work for which application is made and! <br /> comp/y with the State Confractors Law 18.27 RCW and 296 200 WqC. <br /> City of Everett Official Use Only <br /> • FEE <br /> . s� _ 5� <br /> ._____ <br /> --�4...�__ LZ- �-� �,, <br /> � E�Cot2. -- Da �- <br /> OwnerlAuthor' d A nt Signature Date (Revised 10/9?J2095) <br />