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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-267-8810 1 FAX 425257-8857 1 (E) everetteps@_everettvva.gov I www.everettwa.gav/permits <br />PROJECT ADDRESS* <br />BUILDING AREA (If residential, new construction, amodel, or addifi,n) SF <br />,BUILDING TYPE- EI SFR-DETAGHED 0 SFR-ATTACHED EJ DUPLEX U MULTI -FAMILY - # OF UNITS: COMMERCIAL <br />IUSE OrBU[LDIN(3. r2ate-Tt46' EzEf� �—1 <br />Li <br />Pan <br />CONTRACT PRICE OF WORK- $ /a?' age? <br />NUMBER OF DEVICES if low voltage). - <br />FIRE ALARM? 0 YES NNO <br />ASSOCIATED BUILDING PERMIT # (If applicable): <br />DESCRIPTION OF WORK: <br />OWNER NAME- TENANT NAME If Commercial 146 L <br />OWNER MAILING ADDRESS: STREET <br />orry ,07 <br />STATE IJF691221-22 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: &W49&-, eP1-),577eU&'r1Q1J <br />CONTRACTORADDRESS., STREET i0o &V <br />ony mLjg jz-0— STATAA* <br />CONTRACTOR PHONE: 6-2q4-1,0144 <br />_21P!2g,2j!!�4 <br />I CONTRACTOR EMAIL: J+ <br />CONTRACTOR LIC. #QE REQUIRED <br />Q J-. 69y6gCCAV'q0Z <br />CITY OF EVERETT BUSINESS <br />SIN <br />PRIMARY CONTAC <br />- ©OWNER ®CONTRACTOR <br />T: 11 OTHER (Please Specify) <br />CONTACT NAME: <br />L-. p6)qt4ls elf-Dw 1CONTACT <br />CONTACT HONE: <br />EMAIL: DENN 19, �-ADW 0 45-iAll T. d-Oftl <br />AGREEMENT Thereby cerfffy tat I have read and examined this application and know the same to be true and correct All provisions oflaws and apdjaances governing this <br />type of work will be completed whetharspeciffadheralb ornot. The granting of a permit does not presume to give authorflyto Wofate or cancel the provisions of any other state or <br />local law regulating construction or the performance of construciton. That I am authorized by the owner of this property to perform the work for which application is made and <br />complyw1lb the State Confradom Law f8.27RGWard29&20d WAG. <br />Owner (AAorzed Ag'GriSignature Date t <br />City ofEvereff offaial use 0171Y <br />FEE <br /><7 <br />6) 6/ <br />PERMIT# <br />E ['�)-l0,220 <br />(Revised 1011212015) <br />