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LLECTt�ICA PE�MIT' A I�ATI�N <br /> CITY OF EVERETl"PERMIT SERVICES <br /> 3200 GEDAR STREET, EVEREl�T', WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 1 (E) evere�fieps@everetiwa.gov I www.everettwa.gov/permi�s <br /> . .. �... <br /> . PROJECT.SITE:INFORMATION.: . � � . <br /> PROJECi"ADDRESS: � ��"' <br /> BUIl�DING AREA(if residentiat,new construction,remodei,or addition) SF <br /> BUILDING 7'YPE: ❑SFR-D�'ACHED �SFR-ATfACHED �DUPLEX �MULTI-FAMILY-#OF UNITS: OMMERCIAL <br /> USE OF BUlLDING: � �' <br /> .., .. .,: , ... . ... ... <br /> ..: ......:.. . . . .. . ...,, , . <br /> ....: : ..:..:. ... : <br /> ......:.....:. ;;-..:..,::...:.::.,:.....:.:: -,:.:,; ... :�;:: � -:•- ::..-:.: . . .., . .::: . . <br /> .... . : ...... ..:.. ::....... . ::.: .::::::::.ELECTRICALit�PPLICATION INFORMATION. ,..�. .�...:.:. :::.: .:::;. ,. .: : �::,:`:: .:: ...-:.'.: <br /> .. . ...... . _ .. <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voita e): <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMfT#(if applicable): <br /> E?ESCRIPTtON OF WORK: C.', 1�5,(� (/�, (�j � �' (�� <br /> �� � r � --- �� � s,�• � � <br /> w � <br /> . : .. :. . . _ ... . . <br /> . . . . : . : :. <br /> . <br /> . _ ;.: <br /> _._..:.CONTACT`.II+IFORMATl.AN : ` � - <br /> ,, . . <br /> .._ ., . ... .. . .:.... ... .... . ,. .... ... .. . :.;, : :,. .;.w, <br /> OWNER IVAME: � � TENANT NAME(If Commercial): J �' . <br /> l7WNER MAILING ADDRESS: srReEr�`�'�j� �� � � <br /> C� � STATE Y w ZIP �(J3 <br /> OWNER PHONE: "� � OWNER EMAIL: �S ,h �`N <br /> .. . .. . ... <br /> CONTRACTOR NAME: y �,Cj�' � ��1 <br /> GONTRA�CTOR ADDRESS: s-raeEr � � � �j <br /> C� ✓ • STATE ZIP Z� <br /> CONTRACTOR PHONE: Z�' � CONTRACTOR EMA1L: � �(j(/� .(,l:YVI <br /> CONTRACTOR LIC.#(BEQUIRED}: ^ � � CITY OF EVERETT BUSWESS LIC.#(REQUIRED): y' � � <br /> _. .. .:. . . . _. . _ <br /> PRIMARY CONTACT: ❑OWNER NTRACTOR ❑OTHER(Please S ecify) <br /> GONTACT NAME: CONT1aCT PHONE: � Z — <br /> (�1( � � V 1�1 VI`li'� CONTACT EMAIL: � <br /> AGREEIVIENT.-7'hereby certi(y that I have read and examined this application and know the same to be true and correct. AI!p�ovisions oflaws and ordinances governing this <br /> type ot work wi/I be compfeted whether specified herein or not. The granting of a permif does not presume fo give aufhority to violate or cancel the provisions of any other state or <br /> local 1aw regulating consfruc6on or the performance of construc6on. That!am authorized by the owner of this propeKy to perform the work for which applica5on is made and! <br /> comply with the State Contractors Law i8.27 RCW and 296.200 W ///''' � <br /> ��� '��� ��� "���,(�`G ��� ���� City of Everett O�cia1 Use Only <br /> FEE <br /> �ZS �6. �� 3 �tu-� � �l� <br /> � � <br /> PERMIT# <br /> �t o � E � `7�� `" �`f`� <br />