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�CTRICAL PERMtT AP�ICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEQAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � F�UC 425-257-8857 � (E)everetteps a�?everettwa.gov� vuww.everettuva.gov/permits <br /> __ <br /> PROJECT SiTE 11+tFt3RMATtt?N <br /> PROJECT ADDRESS: �j0�03 W Ch5 I t�1 O RD ��%�i T W� 'Q�G�' -'{'j 3.2 <br /> BUILDING AREA(if residentia{,new construction,remode(,or addition) SF <br /> BUILDING TYPE. ❑SFR-0ETACtiED Cl SFFt-ATTACHED C�DUPLEX ❑MULTI-FAM�LY-#�F UNiTS: �COMMERCIA� <br /> USE OF BUt�DiNG: N (.l <br /> ELECTRiCAL APPLICATION iNFORMATION <br /> CONTRACT PRICE O�WORK: $ p� <br /> NUMBER OF DEVICES if fow volta e): � <br /> FIRE ALARM? 0 YES �.NO <br /> ASSOClATED BUiLDING PERMIT# �f a licable : <br /> DESCRIPTIONOFWORK: liUSy�Yb(, �oi4 ��V 'g���-G�� �-� l5�-v Y�n.fL�� ZOfsl/ <br /> Ct?NTACT iNFORMAT101+1 <br /> OWNER NAME. �j TENANT NAME tf Corrimercialj: <br /> OWNER MAILING ADDRESS: srneer �o�p � <br /> cm STATE �/(/� ziP ��2.�- <br /> 01NNER PHONE: OWNEI2 EMA1L; <br /> CONTRACTOR NAME: S U.0`� L L <br /> CONTRACTOR ADDRESS: srx��r S � -- ?,•"�p <br /> CITY �D STATE� WlF�� ZtP Zi' <br /> CONTRACTOR AHOAIE:�'�� CONTRACtOR EMAtL: I�I � <br /> COt+iTRACTOR LiC.#{#tEr�U�R�t3); CiTY Of�VERETT�l7SlNESS�IC.#{REQt�i D): <br /> PRIMARY CONTACT: ❑ODUNER �CONTRACTOR C3 OTHER{Pleass Specify) <br /> CONTACT NAME: CONTACT PHONE; �'LS—Q03—�—T �� <br /> ���„5{ "g�(�.�)(� CONTACT EMAIL: a,Y . b�e.(S.k. �►.f/� SE uo y . w�-. <br /> AGREEMENT•i he�eby�eti�y that i have read and examined this application and know the same to be true a»d correcf. AN prr�visions of lalvs and ordinances goveming this type <br /> of wak rv�71 be compieted whethers�cified he�in or not. The grarrting of a permit does nof presume to give authority fo violate or cancet#ha provisions af any other stafe or <br /> local!aw reguJa6ng conshuctioR or the�,formance of consUuction. That l am authorized by the owner of this property to Aerform the work for which app/icafion is made and 1 <br /> compiy iaith the State Contractors Lau�18.27I2CW and 296.20D UVAC. <br /> � s l� 3� � • 3S <br /> vere �cial Use On y <br /> PERMtT# <br /> � �,�o� - 02� <br />