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/1111 <br /> _ tLECTRICAL PERMIT A LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION. ,. <br /> PROJECT ADDRESS: 1 Le 1. - S j-- 1 v i. 3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ,COMMERCIAL <br /> USE OF BUILDING:rnJ <br /> ELECTRICAL APPLICATION INFORMATION: <br /> CONTRACT PRICE OF WORK:$ I a k <br /> - NUMBER OF DEVICES (if low voltage): • <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: pocTl/ C"6A-.' 1-± <br /> • <br /> :... CONTACT INFORMATION • <br /> OWNER NAME: 12. TENANT NAME(If Commercial): ('�TE-0,1 <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,—cc()(�, E1 <br /> CONTRACTOR ADDRESS: STREET N a5 C 1D <br /> _CITY rJ k C7 l STATE_V/,tj4- ZIP '9 a.'rV <br /> CONTRACTOR PHO E •j -. (,3 C� CONTRACTOR EMAIL:G1cc J YJI�E� =��-r <I nv C` 11c C.�>s ,yl_ <br /> CONTRACTOR LIC.#(REQUIRED): S J r has, .n CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(KT <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: c:9,,x4s, - - r �?r <br /> 6 1/� CONTACT EMAIL: Z� a Cw <br /> 1 <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not The granting of a permit 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 t 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 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 00 <br /> 2-SO - <br /> IPPERMIT# <br /> E f - p S � <br /> Owner/Authori -•Agent Sig ature Date (Revised 10/12/2015) <br />