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- �EC�R��,AL PER�V[IT' �� ���,�T`��iN
<br /> CITY OF EVCRETT PER?`�1f7 SERVICES
<br /> 3200 CEDAR STr���T; EVERETT, Ut`A 982�i
<br /> (P; 425-257-88�0 i FAX 42b-2�7-885? ; ;�) evere�eps@evere�va.gov 1 wuwv�.evere�t�a�a.ge��Jpermits
<br /> RROJIECT SI'I'� tN�ORPJIA�'I�N
<br /> PROJECT ADDRESS: �OO (���;���, �J� r L�Lk� �� �� •
<br /> BUILDING AREA(i=�esider.uai, �w ccns`ruct:on; ;e!;,ode1, or addition} gF
<br /> BUILDi�vG TYPE: ❑SFP,-DEiACHED ❑S,=R-A i fACN_D Cl DUPLEX ❑ �v9ULTl-FAiV11LY-�Cr=uNi I S: �COA��t�-iERCI�
<br /> USE Or BUiLp}NG:
<br /> EL�CTRICAL APPLICATIOM INFOR�AATION
<br /> C0�'TRACT PRICE OF WORK: $ , ��,`"L
<br /> NUMBER OF DEV(CE5 (!i IOW VO�.a e):
<br /> FIR�ALARM? ❑YES ❑ (�p
<br /> ASSOCIATED BUILDING PERMIT�{if aopiicaole}:
<br /> DESCRIPTION OF 1/�ORK: �. v� - C�,.� Q,i� �-�.�' �G u l�;u� 2'�l� I—�� _
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<br /> CONTACT tNFORMATION
<br /> OVYNER NAME: �C'��u�t�.G.n�� <;��i ,,�' T��q�-�NAME If Commercial}:
<br /> OYVNER MAILtNG ADDRESS: s�e�
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<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: tC.h� �(�k'�(,,,.
<br /> CONTR!?CTOR ADDRESS: s;�=_, ' '�'�-`� ' '�J. r`U�:� �„
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<br /> CONTRACTOR PHONE: i�t,;, -'�f'�(,;� :�2�:C; CONTRACTOR EMAtL:
<br /> CONTRACTOR LlC.#�RE�2UlRE�7) 4 C�c.�;.irc�.T'-et��L
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