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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 � wuvw.everettwa.gov/permits <br /> ���� , �� � �'RO�I��CT S�?E INfORMATIQA+I ;. <br /> PROJECT ADDRESS: y°p( E �Yl� � C <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: FR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATlON INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES �NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: (y �-L �[S`v-v��►��c �Ec�-s,.►�1�.C� <br /> � � L��.�� <br /> CONTACT INFORMATION <br /> OWNER NAME: �(����}- �q/ �t.��V�+� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREeT ( �L L^lt. L(Ar(b� <br /> cirr Lti��'Ll%'r'�— STATE �- ziP ���?j <br /> OWNER PHONE: ��" �( �� l OWNER EMAIL: <br /> CONTRACTOR NAME: L!N�L k. �Z�C C��IG.-- <br /> CONTRACTOR ADDRESS: srReeT ?(Y� (,�'D �` �� /�C <br /> CITY L�Vj�.��� STATE L�/`t ZIP ��� <br /> CONTRACTOR PHONE: �- �� - '� CONTRACTOR EMAIL: �'t� ���([�-e-✓�C�c�Yt c. ��� <br /> CONTRACTOR LIC.#(REqUIRED): ' �' - .� �,• �j CITY OF EVERETT BUSINESS LIC.#(REQUIRED): `6 I G K <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �f�=$��-a�89 <br /> ���J�k-C�-�:�l�C-�C�- CONTACT EMAIL: Uj�l� �k '`��L�,�� •b"�. <br /> AGREEMENT:1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work will 6e 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 regu/ating construction or the pe�formance of construction. That I am authorized by the owner of this propeRy 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 ��� `—'" `� � � <br /> '� � c� � � �., , . � <br /> Owner/Authorized Si ature Date (Revised 9/23/2016) <br />