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i�J� <br /> �ECTRIC <br /> AL PERMIT APpL1CATI�N <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 J wwuv.everettwa.gov/permits <br /> , , ; .. .�. .. <br /> ,.._ <br /> PROJECT SITE INFORMATION'` '. ` <br /> _ . - ,. _: ... ,_ . . _ - <br /> PROJECT ADDRESS: �"�' s� �' � � (�7 ZC� <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF � <br /> BUILDING TYpE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX IaMULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: �j„ .� � � <br /> , .. ,. <br /> >.; ., <br /> , ELECTRICAL APPLICATION INFORMATION <br /> . , _ . .. :.. ,.. , , . . . <br /> �. .. _ _. .. _ , , .. _. : : ;: <br /> CONTRACT PRICE OF WORK:$ �� . <br /> NUMBER OF DEVICES(if)ow volta e :� <br /> FIRE ALARM? ❑YES ❑NO - <br /> ASSOCIATED BUILDING PERMIT# if ap licable : <br /> DESCRIPTION..OF WORK: � b� ,��� �� � ..r <br /> _ <br /> -_ , <br /> . <br /> .. , ,. . _. <br /> . _ . , : CONTACT:INFORMATION . - <br /> : . .. - _.. ... _. <br /> OWNER NAME: �N(��C ' TENANT NAME(!f Commercial): ( <br /> 01NNER MAILING ADDRESS: srReEr� -tl�.'� S <br /> � �r^" sra-rE'W 1L vP <br /> OWNER PHONE: OWNER EMAIL: <br /> . .. , ...... . .. .... . . . ... . .. .. .. ... . . . ...... . . . .. _ <br /> CONTRACTORNAME: ��r[r "l"(IJ VLC.LS <br /> CONTRACTOR ADDRESS; Z��� � �V� � <br /> b o�hcw�,�nn�.. r�.ts �F �A�` W '' <br /> ZIP <br /> CONTRACTOR PHONE: Ck2��L�L.�`-S Z CONTRACTOR EMAIL: —S �t-� .`�Z'� ,e�� � �y�ti <br /> CONTRACTOR LIC.#(REQUIRED): ��c � c� �l/�,3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�� � <br /> PRIMARY CONTACT: �D OWNER LONIRACTORw ..C7.OTHER Y�Y.Y,L�W.,Wy _ _ <br /> (Pfease Specify) <br /> CONTACT NAME: GONTACT PHONE: ��Z���-Z?� • <br /> ,:I t>�I� NE�j� CONTACTEMAIL: s(�J (o3ZS � �STI � Go,�,/�� <br /> AGf2EEMENT.�T hereby cedify fhat i have read and examined this application and know the same to be frue and correct. Al!provisions of laws and ordinances governing this <br /> fype of work will be completed whether specif'ied herein or not. The granting of a permit does not presume to give authorify to viofate or cancel the provisions of any other siate or <br /> loca!law regu/ating construcfion or the performance of consUuction. That l am aufhorized by the owner of this property to perform the work for which appiication is made and 1 <br /> compiy wifh the State Contracfors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett O�cia!Use Only <br /> • FEE <br /> � s�-r -s� <br /> PERMIT# <br /> ---�,...�__ �Z- �-� � � E t l�C 2 -o�.� <br /> OwnedAuthor' dA ntSignature Date (Revised 10/92/2015) <br />