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ELECTRICi�L, PERMtT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982fl1 <br /> (Pj 425-257-8810 � FAX 4-25-257-8857 ( (E)everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROdECT S{TE ONFORMATlON <br /> PROJECTAODRESS: �3 i����.'"t..t,-L'1.�� /Z"�'�- �' +n-"'" �' <br /> BUILDING FiREA(if residential,new construction,remodei,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ULTI-FAMILY-#OF UNITS: { � ❑COMMERCIA� <br /> USE OF BUILDING: <br /> ELECTRfCAL APPLICATiON INFORMATION <br /> CONTf2ACT PRICE OF WORK: $ .� ` L-� <br /> NUMBER OF DEVICES if low volta e : � <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOC9ATED BUILDiNG PERMIT# if a plicable : ' <br /> QESCRIP7tON OF WORK: -�-% � "7"�����-�`� ��� �����p��'� <br /> . �..���.�.C.�. <br /> CONTACT tNFCIRMATIBN ` <br /> OWNER NAME: <br /> � � � ,�,j y'}.�,",,� TENANT NAME If Gommerciai}:• ,j,�. -��I� <br /> OWNER MAILING ADDRESS: sixeeT �+f:� �C.. I+���'L�--��. <br /> CffY <br /> -'��'"�s�V-l./��t STATE d ZIP � �!��! <br /> OWNER PHQNE: ��j . ��C�° ���� OWNER EMAIL: <br /> CONTRACTOR NAME: �� ►(,/�'� ��Z.�� `�e�-- �- �' �-� .�� ` <br /> CONTRACTOR ADDRESS: srREEr ° � ���'�" .�'` J �°���- � � -' <br /> CIIY !Y ":�.7��� � STATE 4�"4-s s�°"�� ZIP ��L7 P'$,..y,•°� <br /> �. . <br /> CONTRACTOR PHONE: — � 7f CONTRAC70R EMAIL: . � "� �f� = ���°� �� �-- � <br /> CONTRACTOR UC.#(REQUIRED): ��Y/�F��Y�1 �����-� CITY QF EVERETT BUSINESS LIC.#(REQUIRED � �-�7�-t <br /> PRiMARY C4NTACT: �OWNER I�ONTRACTOR ❑OTHEft(Please 5pecify) <br /> CO TACT NAME: l"^ CtyNTACT PHONE: x' �-�'"„„') • ��"�,_...s��' �, <br /> °���(,�.� � � ��`�, AJ�;���. cor�TAcr Enn,v�: �y-- ,����i� 1� ' , .��4 <br /> AGREEMENT.�t hereby certify that r hav}r�and examined fhis appfication and know fhe same to be frue and correct. AI!provisions of laws and ordinances governing this type <br /> of work wilt be completed wheiher specrfied herern or nof. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stafe or <br /> local Iaw regutatrng constructron or fhe performance of constructron. Tirat!am authorized by the owner of this property to periorm the work fo�which app/ication is made and J <br /> compfy with the State Confractors Law?8.27 RCW and 296.700 WAC. <br /> City of Everett O�cial Use Only <br /> ! PERMIT# <br /> ' ^�,,...3 .�� E ( -- �.� �i <br /> �� C�l��-_ � ��� <br /> IOwnerlAuYhorized Agent Signature Date (Revrsed 9/23/2096) <br />