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} <br /> � <br /> " 1� - lCa O�.X <br /> � <br /> c : <br /> ` ELECTRICAL PERMIT APPLICATION <br /> CITY O� EVERETT PERMIT SERVICES <br /> - 3200 CEDAR STREET, EVERETT, WA 98209 <br /> s <br /> � (P)425-257-8810 � FAX 425-257-8857 � (E) everet�eps@everetfwa.gov � www.everetfwa.gov/permits <br /> 1 ?- Y *l fti s� z�� <br /> � s... . . . � , . u �. � , ��; �i' ��^rL���{��� x� ,� <br /> �d r��.� '�iES??m' <br /> PROJECTADDRESS: 2D SW E.VEC-��TT IV4I�LL. wPrY <br /> BUILDING AREA(i#residerrtial,new construction,remodel,or addition) Z�'p SF <br /> � BUII.DING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACFEED ❑ �UPLEX ❑ MULTI-FAMEL.Y-#OF UNITS: COMMERCIAL <br /> • USE OF BUItDING: W e s fi r c�, S U 1r-�cj - �.2�-L;�` <br /> � <br /> � <br /> �6 CONTRACT PR[CE OF WORK: $ yl`��'o <br /> y NUMBER OF DEVlCES if lowvo a e : <br /> FIREALARM? l7YES �_..__�7`(VO <br /> ASSOCIATED BUILDINO PERMIT# if a licable : <br /> � DESCRIPTIONOFWORK: `�Qvkn e�Pc�'(if4� �ow P�C�$�1� �k�.a�.•f' <br /> � <br /> F <br /> � <br /> � <br /> � OWNER NAME: TENANT NAME If Commercial]: WC�S+rq S dY'�-S <br /> � <br /> OWNER MAIUNG ADDRESS: STREET <br /> � <br /> C1N STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: ; <br /> . .._...._..___.___.___---...._____�__�_____�____... __._ _._. .. , .---..___._,__. <br /> i CONTRACTOR NAME: E L E CT�l— C �"r�J � �N C- <br /> CONTRACT�R ADDRESS: sTREEr �Z�I I Z Q�v�l�L '�A�K R n E <br /> CITY MU 1�,1�-TE� STATE W A ZIP �l�L�� � <br /> � CONTRACTORPHONE: y�ZS `z- CONTRACTOREMAIL: � Rls�@ E�.Ec.TR -C 1 � NC • CO Y <br /> ; CaNTRACTOR L1C.#(REQUIRED): CITY OF EVERETT BUStNESS LIC.#(REQUIRED): i <br /> ; . . .. . ..._ . . . .....�._ _ .........« . _._ ... . ... _.. . ....:.:..._... ..�. G <br /> ; PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) � <br /> CONTACT NAME; CONTACT PNONE: t}'z5 {0�2- �-� fi <br /> P�R1SA [�21c�pRL�SnN CpNTACT EMAIL: � <br /> Ya t2ts�@ E�ec-r-�t- c� _ co�n <br /> , AGREEMENT.'T heveby aeriily that I hat+�ie�ad and examined 6his applicatfon and know fhe seme to be Gue and carecL ,4A provislons of laws and otdlrtances goveming this <br /> , iype of woAc wiB be onn�pleted wl�ther specHled hsreln o�noL The grdnGng of a pemvt does not presr�me to gnre auttrority to vlolate or cance!tl�e proNsYons of any other state or <br /> bca!(aw regulati�constnrcUon or Hre performartce o!canstnic[fon. That!am eufhorized by the rnmer of flris proparly to peNam the x�ork lor whlch applrcatidn is macb and! <br /> compry wifh�he State Contradofs Lsw 18,27 RCW and 296.200 WAC. <br /> Clty of Everetf O/flda!Use Only <br /> FEE � <br /> �� ' � � i <br /> i <br /> PERMIT# � <br /> 7 t2 E ��� — d� � � <br /> O erlAuthorized Agent Signature Date (Revised 10/12/2015) <br /> � <br /> fi <br />