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E�CTRICAL PERMIT AP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEQAR STREET, EVERETT, WA 982Q1 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE.'INFORMATIUN <br /> PROJECT ADDRESS: �D �1 �' � <br /> BU1lDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: FR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULT�-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: � <br /> ELECTRICAL APPLICA710N INFORM/#TION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? �YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> _. . _ __ __ _ <br /> __ _ , <br /> DESCRIPTION OF WORK: S'C� l <br /> �' � 1D '`�p � <br /> � 2 • U • .r- � ' �- <br /> � <br /> �CONTACT �NFORMATIQN <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREEf <br /> CRy ' STATE Z,P v� <br /> OWNER PHONE: �S^'�"' 7- {, OWNER EMAIL: �P Y�Ytl1'��S'�� <br /> CONTRACTOR NAME: Ar C��Z�►� ' <br /> CONTRACTOR ADDRESS: STREEf �� ?J�� `SG <br /> CRy STATE ZIP <br /> �QNTRACTQR PHONE. 33�I'3C�Ol.Q CONTRAGTQR EMAIL: ('W Wt���'�� <br /> CONTRACTOR LIC.#(REqU1RED)��I'I" � 1�0��L.(,Q CITY OF EVERETT BUSINESS LIC.#(REQUIRED) <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L-�"�j�'�j�j'\�� f <br /> �'��� �,�L.�� CONTACT EMAtL: �`� C���1.(��� <br /> AGREEMENT:I hereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority fo violate or cancel the provisions of any oiher state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply ivith the State Contractors Law i8.27 RCW and 296.200 WAC. <br /> . <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E l�l d�" l ��O <br />