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ELECTRICAL PERMIT APPLICATION <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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: �� C��L,{f ��,I�'%(L1 ��, � Gi�c.U% <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: <br /> � <br /> ELECTRICAL ;APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: ' / � � ��' <br /> NUMBER OF DEVICES (if low 'oltage): <br /> FIRE ALARM? ❑YES `��_ ___ � <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ' l � ` � E: - ^ � - �7.�; ' <br /> �..i�-c� ! � / � 'i� ���.! -� _ j Ct�' C <br /> ,,, CONTACT INFORMATION <br /> ---. <br /> OWNER NAME: �� r v c�� 5 TENANT NAME If Commercial): <br /> OWNER MAILING ADDR�SS: srREET % S S ��i �L�����,��7 {G�c�-' �h-- �-� /�' <br /> G, l--i C . L.L- CITY STATE i C ZIP C' Z,C� <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: S E c� C.L� , L ��i-/� � �-L- 1 C. <br /> CONTRACTOR ADDRESS: srReer �('�/ �i � fi����� L+-C� <br /> CITV � -I _�'��.� STATE �i�C� ZIP �-, �-��_.._ <br /> CONTRACTOR PHONE: r -� - , � -� `� CONTRACTOR EMAIL: C.G.!` �L '. ! <� C� CC'66 `�� <br /> Z� ` J� � c_ ( C (_ C c'_ c` eet � `y <br /> CONTRACTOR LIC.#(REQUIRED): S- � y ( CITY OF EVERETT BUSINESS LIC.# EQUIRED)• <br /> � <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) � j�� `c � <br /> CONTACT NANL�: CONTACT PHONE: , �-�� �CJ <br /> 7 <br /> C�(fc'(5 �� � CONTACT EMAIL: �� � � � �; � c� � S (��C� c�( ; �c� a�`. <br /> AGREEMENT.I hereby certi that I have read and examined this application and know the same to be true nd 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 to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That/am authorized by the owner of this property to pertorm 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 Official Use Only <br /> � PERMIT# <br /> � -- �-- �i � ►�7 E �� -ol� <br /> Own rized Agent gnature Date (Revised 9/23/2016) <br />