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����'��� �� ��� �������� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, WA 98209 <br /> (P)425-257-88'10 � FAX 425-257-8857 � (E}everetteps@everettwa.gov j www.everettwa.gov/permifis <br /> ,. _ ,.. <,.. _ ..._ _ <br /> . <br /> ' ' PROJECT SITE INEORiwAT1AM: <br /> PROJECTADDRESS: �'a1�S G�Z.P+�TSQv���v �l��( <br /> BUILDING AREA(if residenfial,new construction,remodel,or addition) SF ' <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OP BUILDING: � <br /> , , ... ' <br /> --- <br /> " ' ELECTRICAL APPLICATION INFARMATION <br /> CONTRACT PRICE OF WORK:$ � <br /> NUMBEE2 OF DEVICES(ifi low voltage):� <br /> F1RE ALA.RM? ❑YES ❑NO <br /> ASSOCIATED BU(LDING PERMIT�#(if applicable)_ <br /> DESCRtPTION OF WORK: i 2 <br /> �2 �� �t.)»" �sz.v� — - <br /> : ,.,. .. ... .... . . . .. <br /> . ... . .._ ._ . .. <br /> � . :.. <br /> ., , _::: .:.: . . .:-: ._.__ : � :.. .CONTACT INFORMATION_ ..: - <br /> OWNER NAME: P� ; p�:• y r' �'i, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: � srReEr <br /> CIIY � STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTO:R NAME: � �J L.l. W U �- C-• <br /> CONTRACTORADDRESS: s-rReEr -�. ^tZ., �c��� <br /> cirr srAre �,,.3�6 <br /> CONTRACTOR PHONE: • �L�. � S CONTRACTOR EMAIL: �" l �' � �'�$� jZ <br /> r.wac �.-- <br /> CONTRACTOR LIC.#(REC�UIRED): ��� L L` �)�,�... " `j" CtTY OF EVERETT BUSINESS LIC.#(REQ 1RED): � <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR OTHER(P(ease Specify) L���r� <br /> CONTACT NAIVIE: CONTACT PHONE: �g�(� — C� �� -- "�.S-�(p � <br /> � <br /> ° � ..�-�-ss-�-L CONTACT EMAIL: , `���N� H,�L-t., W�=�.�Z1 �1-iT� � � 12 <br /> AGREEMENT.•T here6y certify that(6ave read and examfied this appiication and know the same to be true and correct. AI!provisions of laws and ordinances governing this <br /> type of work wi!lbe completed whether specified herein or not The granting ofa permit does not presume to give authority to violate or cancei the provisions of any othersfate or <br /> /oca/!aw regula6ng construction or the performance of construction. That!am authorized by fhe owner of this property to perform the work for which application is made and l <br /> comply with the Stafe Contractors Law 98.27 RCW aad 296 200 WkC <br /> City of Everett O�cial Use Only <br /> FEE <br /> � �2� ,�� <br /> PERMIT# <br /> � � � . , �l �Z- I � <br /> � <br /> Owner/Aufhorized Agent Signature Date (Revised 10/12/2095) <br />