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477 ELECTRICAL PERMIT APPLICATION <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: 412_ LQ u-VC I OR , -ve Vie'- wpcq"V 2_0 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED J SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 9-f 1,-1(kiln j <br /> ELECTRICAL APPLICATIONINFORMATION <br /> CONTRACT PRICE OF WORK: $ 7 Lino <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES -IZNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): �n <br /> DESCRIPTION OF WORK: fjQ±6'1 f 2{//1 o cf — UC �/I l��/(it�!fs, 12S" GWnp <br /> csv.bp flaDY heo7L <br /> CONTACT INFORMATION <br /> OWNER NAME: ?OL2 1 /v v TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET '1/2 <br /> JJ -64 re-1 1.)eCIN Fvei STATE 144- ZIP 2'2/.1 <br /> OWNER PHONE: 712 <br /> Jam• OWNER EMAIL: A//A <br /> CONTRACTOR NAME: /`f 1/DWS2 rl ec G r/ Ce7e/ -ev-ttc eJ///G• <br /> CONTRACTOR ADDRESS: STREET <br /> : <br /> CITY La C -&/vVpv/ J' STATE 9' ZIP ID2-9 <br /> CONTRACTOR L � rJ� N� TOR EMAIL: <br /> ��� � � /r�� <br /> � <br /> CONTRACTOR IC.#REQRED) /AI ���� � CITY OF EVERETT BUSINESC.#(REQUIRED): 4‘;78 <br /> /0 U <br /> PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ( 2/2 )2 SO- -q--/q0 <br /> CONTACT EMAIL: N/�- <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true areccorrect. All provisions of laws and ordinances governing this type <br /> 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 I 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 18.27 RCW and 296.200 WAC. <br /> / / City of Everett Official Use Only <br /> etr / PERMIT# <br /> ��/��/ E ISO 1 -- 11 <br /> Owner/igprzed Agent Signatur= Date (Revised 9/23/2016) <br />