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.ECTRICAL PERMIT AF : _ICATION <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: � � _W . �C�� ��4L�� lti L�1 ��s <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 /> ECTRI AL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ �c:�w <br /> NUMBER OF DEVICES (if low volt e): <br /> FIRE ALARM? ❑YES ❑ <br /> ASSOCIATED BUILDING PERMIT# if applicable : <br /> DESCRIPTION OF WORK: ..Qsyt ' '�z.- S(' � ��'l(:�� G-t"�lt%"��%�'?' � - ��b <br /> 'F' � 'T�-t ' �+.i�"' <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer <br /> cro sTn� ziP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �^,(VC— W <br /> CONTRACTOR ADDRESS: srrtEeT � �� ' (.'�` rLe� �°J S . <br /> cirv k'i',�>�fL �•+ sTnrE " a� � i,`r ' <br /> CONTRACTOR PHONE: �� � �3� (ti' CONTRACTOR EMAIL: CVLi�'1�-'-�'�r �'... ' ���Vl(�C�C" <br /> CONTRACTOR LIC.#(REQUIRED): �'�'J�J�U� �� Q7 CITY OF EVERETT BUSINESS LIC.#(REQUIR : � � <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACTNAME: CONTACTPHONE 11�� ��]L.�-�—?j �(��y <br /> �����'��-9"� CONTACT EMAIL: � <br /> <�L•'� r0 1'►t7 c�, CF� `�.��� C: <br /> AGREEMENT:1 hereby certify that!have read and examined this application and know the same to be true and correct. AU provisions of laws nd ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permrt 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 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 Official Use Only <br /> PERMIT# <br /> � �� � � � � E �� � � o � <br /> Owner/Authorized A nt Signature Date (Revised 9/23/2016) <br />