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CTRICAL PERMIT AP CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9$201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.govlpermits <br /> ' ` , P�t'�JECT�1"i'E�1�1��?R�flIAT�CtN ,, <br /> �. �. , <br /> ,. ._.. ,_, . _ _ ._��...�. . ._F. <br /> ,, , r .. ,� . .,_ <br /> PROJECT ADDRESS: ��.I S� � �P�YiC+ �/1�I( <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED �SFR-ATfACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUiLDING: <br /> =ELECTRICAL APPLICATit�N iNFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES if low volta e : � <br /> FIRE ALARM? ❑YES �NO <br /> ASSOCIATED BUlLDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: <br /> �„ � � L a.�,►�. �. �c � <br /> C«N7`ACT INF�I�MATI�N <br /> OWNER NAME: � � p ctr . _ TENANT NAME If Commerciai): S . q '�c. <br /> OWNER MAILING ADDRESS: STREE7 � 9 <br /> Cf1Y ,�/t/11U� STATE ZIP � <br /> OWNER PHONE: a�-- �' ��Cf� OWNER EMAIL: <br /> CONTRACTOR NAME: � � � y � � <br /> CONTRACTOR ADDRESS: srneEr (oa-I a �� �J p� t� <br /> cm (� � srn� �J4' rP � p �� <br /> CONTRACTOR PHONE:� o� — 3O ` ��(9� CONTRACTOR EMAIL: '� (' v1 Q �/1 S , C <br /> CONT R 1 . ( UI CITY OF EVERETT BUSINESS LIC.#(REQUIRED: <br /> �....,µ,., _� ..v .. . _ ,�,li., , . .._ _.. �,_... . <br /> RRIMARY CONTACT: O OWNER ❑CONTRACTOR (�OTHER(Please Specify) Si �n G1 � � <br /> t� c Lv�i� <br /> CONTACT NAM� CONTAGT PNONE: C�� ,- �'� <... u�'� <br /> I..e CONTACT EMAIL: ✓��y� � e �,.�-�' � (�y� <br /> AGREEMENT.-!hereby ce ' at 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type <br /> of work will be completed whether spe�ed herein or rtot. The granting of a permit does not presume fo give aufhori(y to violate or cancel the provisions of any other state or <br /> locaf/aw regula6ng construcUon 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 with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett O�cia!Use Only <br /> �� PERMIT# <br /> a � � E �,�-� � 0622.. <br /> Owner/ rized Age 'gna re Date (Reviseal 9/23l2016) <br />