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�LECTRICAL PERMIT AP�LICATION <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� www.everettwa.gov/permits <br /> °' PMtt���`T�1'�'����t��l�4'�'141� �' <br /> � � <br /> PROJECT ADD� _ ��� : a .: .:�,�. , v, � �r _.�� ,. , �_ ,_ . � r�s_.._ . � ,.,�, <br /> �_ . ... . . �, .� <br /> RESS: � ��7 Q,l���" G� -�' 2 y�i <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �1COMMERCIAL <br /> USE OF BUILDING: ��Vv1 •�?,' <br /> ' EGEC'�'R1CA1.�11'�PLIC1d1?`It"yN 1#�I��R�lT10N'; ` <br /> CONTRACT PRICE OF WORK:$ �a"� <br /> NUMBER OF DEVICES if low voita e : `� <br /> FIRE ALARM? ❑YES �9 NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: <br /> �Gl �C3� p � C�nc?. <br /> �p c; <br /> ! <br /> ` COI�1'TAC�"��iF�C�MlA�'�'IQ�I <br /> . _ , ,_ _, r . . � � _ . , _, �. , , n_ <br /> _ _. <br /> OWNER NAME: � ' ..� TENANT NAME(If Commercial : � � v�Ui.��Q <br /> OWNER MAILING ADDRESS: STREET (�� '�' <.l..-y,11 ��, � �./ #�� <br /> CITY���QNC� STATE � ZIP��V <br /> OWNER PHONE:�I � � —��'I C)Cj OWNER EMAIL: <br /> CONTRACTOR NAME: t� �� .�r � � <br /> CONTRACTOR ADDRESS: s�eer I � 1� � � <br /> CITY �T�� c STATE � � ZIP � U� <br /> CONTRACTOR PHONE: a- — (j "�I CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED: g��S ��L� CITY OF EVERETT BUSINESS LIC. REQUIRED): �T� <br /> ,,, N� ,,._�.. . �.. �, ., .__ , ,. .,,.- .. � _ ,, r, . ... . �._ �_�.� � . ,. <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR �B:OTHER{Piease Specify) Si �.�,Q.� <br /> CONTACT E: � CONTACT PHONE: L,-(��_ , ?J.— � <br /> � � CONTACT EMAIL: � � � �r� <br /> � <br /> AGREEMENT.•7 here certify that I have read and examined fhis app/ication and know the same to be tru� d correct. A/l provesians of laws and ordinances goveming this fype <br /> of work will be compl whether spe�ed herein or not. The granting of a permtt does not presume to give authority to violafe or cance/the provisions of any other state or <br /> local law regula6ng construction or the performance of construction. That l am authorized by the owner of this property fo pe►iorm the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Officiaf Use On/y <br /> �/� PERMIT# <br /> � �i E � ��3- <br /> � <br /> Owner/Authorized Agent re Date (Revised 9/23/2016) <br />