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1,41111, 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 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION - <br /> PROJECT ADDRESS: t/0( e,) <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS: Cf COMMERCIAL <br /> USE OF BUILDING: c9� e <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 3 Qa) so <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ,0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Aid Dc/-f"1eeb <br /> CONTACT INFORMATION <br /> OWNER NAME: 6(A)? (&7 TENANT NAM f Commerci <br /> AA/.. <br /> al <br /> OWNER MAILING ADDRESS: STREET / C .( d rl� <br /> CITY STATE ZIP <br /> OWNER PHONE: c/Z,S - 530'"-23 73 OWNER EMAIL: <br /> CONTRACTOR NAME: /C.-/f'/ �`ylrycij�c <br /> CONTRACTOR ADDRESS: STREET Pa /2...-7 <br /> CIT,' yah ed STATE teal l- ZIP'FPO Y6' <br /> CONTRACTOR PHONE: y4,- - 2/0 --/SV zv>7 CONTRACTOR EMAIL: Se---7, 1- 4''7e Q ftt)C, �o✓�'i <br /> CONTRACTOR LIC.#(REQUIRED): /Atry1/7 C.1 CJ -/Z� CITY OF EVERETT BUSINESS LIC.#(REQUIRED)31 ti ? <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: yes- zJO / 'y <br /> JC- CONTACT EMAIL: c4A.7, 4r-37r ® kiktc, L 7 <br /> AGREEMENT.'I 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 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 /> PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />