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,ECTRIGAL PERMIT AF LICATI�N <br /> CITY OF EVERETT PERM�T SERVICES <br /> 32�0 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-881� � FAX 425-257-8857 f (Ej everetteps a�everettwa.gav � www.everettwa.gavipermifs <br /> PROJECT SITE INFORMATiON <br /> PROJECT ADDRESS: 2323 Lexin ton Ave; Everett, WA 98203 <br /> BUILQING AREA(if residentia[, new construction, remodel,nr addition)475 SF <br /> BUfLDING TYPE: � SFR-DETAGHE� Cl SFR-ATTACHEQ ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: D COMMERCIAL <br /> USE OF BUILDlNG: Defiached Gara e <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 500 <br /> NUMBEFt OF DEVICES if low voltage}: <br /> FIRE ALARM? C1 YE5 C�J NO <br /> ASSOCtATED BUILDING PERMtT# if applicable : <br /> DESCRIPTION 4F WORK: R@Wii'� Cl�tatChed arage <br /> �-�s �Y'r G-c..�- r'�e'�✓t i�[�' <br /> CaNTAGT 1NFORMATION <br /> QWNER NAME:RObBt't JaCqU�S TENANT NAME If Commerciai : <br /> awtiE�nna;iuN�aaaR�ss: STRE�2323 Lexing�on Ave <br /> �R., Everett STATE VvA Z,P 98203 <br /> OWNER PHONE: 360.620.1918 OWNER EMAIL:rqb.J�CC�U�S�y'�hUO.COCCI <br /> CONTRACTOR NAME: OWt1Gl" <br /> CONTRACTQR ADDRESS: srREeTSame as owner <br /> �� STATE ZIP <br /> CONTRACTOR PHONE: Same as owner CONTRACTOR EMRIL: Same as owner <br /> CONTRAGTQR LIC.#(REQUiRED): QWC1er CITY OF EYEf2ETT BUSINESS LIG.#(REQt1lRED): <br /> PRIMARY CONTACT: � OWNER ❑CONTRACTOR O OTHER(Please Specify) <br /> GONTACT NRME. CONTACT F'HONE. ��'j(},6��.���$ <br /> Rob Jacques GONTACT EMAIL:rQ�.j,�cq�es@yahoo.GflCll <br /> AGREEAAENT.•!here6y cerfify that!have read and examined fhis appticafion and know the same to he true and carrect. AIJ provisions of7aws and ordinances goveming this type <br /> af work wi(!be aomptetad whefher specified herein or not: Ths granting of a permit does not presume#o give authorify ta vir�tate or cancel the provisions of any othe�stats or <br /> local law regufatrng construction or fhe performerree of construction. That 1 am authorrzed by fhe awner of this property to parform the work for which application is made artd f <br /> compiy with the State Contractors Law 18.27 RCW and 296.200 WAC, <br /> Cify of Evereft OHicial Use dnly <br /> PERMIT# <br /> JI� ��� E - `"�n <br /> ____�. � <br /> Owner/Au#h zed ent Signature Date (Revised 9/23/2016) <br />