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� <br /> -------- -------...�_.__..... __.--- <br /> ----_—__—_ �����1����-- - - - ���,��.�������-----____.�.__._____._�._. <br /> CITY OF EVERETT PERMIT SERVICES. <br /> 3200 GEDAR STREET, EVEREI-f,WA 98209� <br /> (P)42�-257-8810 ( FAX 425 257-8857 � (E}everetteps@everettwa.gov l www.everetfwa.govlpermits <br /> ' _ . �: : `." PR@JEC'T SITE 9NFORi1�ATtON <br /> . . . . . .. . . . .. . . . ._ _. <br /> ... .._._� . . ..... ... . .. ...... �..., .._ . __ , _ _. . . <br /> PftOJECT ADDRESS: �iQ'� �� v¢xe a 1 � �� <br /> BUILDING AREA(if residenfial,new construction,remodel,or addition) SF ' <br /> BUILDINC tYPE: ❑SFR DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULT!-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OP BUILDING: COmI'Y�2JfGlCt 1 • <br /> .. _ ..._ _..-.._._... . .. . _., • <br /> ,_ . _ .... <br /> _. , <br /> .: <br /> - - :: ELE.CTRICAL APPLICATION 1NFORMATION - �' <br /> CON7RACi'PRICE OF WORK:$ 8� � <br /> NUMBER OF DEV(CES(ifi low vo{tage):� �1 <br /> FiRE ALARM? ❑YES CI NO <br /> ASSOCIATED BUILDING PERMIT#Cf applicabfe): <br /> DESCRfPT10N OF WORK: P1 � ! <br /> :- �- -...;.. . ... ... _..:. ......-. .. ._ �- ... , . <br /> . . , . . .. , :....... . . _ .. .. .. : . . _ - <br /> •� : . - � _:: ..GONTACT INFORNIATION.,:._ � . . . .. . <br /> OWNER NAME: � TENANT NAME(if Commerciat): <br /> OWNER MA{LING ADDRESS: snt�r <br /> CfIY STATE ZIP <br /> OWNEi2 PHONE: ' OWNER EMAIL: <br /> CONTRACTO:R NAME: �T 1 1'1 <br /> COT�TRACTOR ADDRESS: s�xEEr -� � e � <br /> CIiY t� STATE v v ZIP Q <br /> CONTRACTOR PHONE: �f' •�v3C�.8 I�OO CONTRACTOR EMAIL: � l 1'1,$ Y►'ZS()•�o <br /> CONTRACTOR L.IC,#(REQUIRED): T LS"� � 0 ` v�t CITY OF EVERETT BUSIiVESS UC,#(REQl1IRED); O��"J� 1 O�" <br /> PRiM�RY CON7AGT: ❑OWNER ONTRACTfJR�NC!O'THER(Ptease Specr(y) v <br /> CQNTACT NAME: �Y>� Ct3�3TACT PHQHE; �Z�" Q ' b� <br /> < CONTAGT EMAIL: � �,)n • Cp y�l <br /> RGREEMENT T hereby certify thaf!have read and examined this apprca�ion and know the same fo be true and rrect All provisions oflaws and ordinances governing ihis <br /> fype of work wil(be completed whether specified herein or not. The granfing of a permr�does not presume fo give authority fa violate or cancei the provisions of any otherstate or <br /> (ocai law regufating constnrctron or the performance ofconsfn�ction. That!am author¢ed by fhe owner of this property fo perform the work for which applica6on is made and 1 <br /> comply uvr7h the 5hate Confracfors Latv 18.27 RCW aad296 200 WAC <br /> City ofFverett�cia!Use Only <br /> FEE <br /> � �\� °� <br /> � <br /> � PERMIT# <br /> �j-Z-3� �7 � - (� <br /> O er/ ufhorizedAgentSignat e Dafe (Revised 10/12/2095) <br />