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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 vwvw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: L (/t�C�7` ca,f1/fG /Za vere iJ SZO ( Y <br /> BUILDING AREA(if residential, new construction,6emode)or addition) 2.6"--0SF w/ <br /> � <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED ElDUPLEX 'MULTI-FAMILY-#OF UNITS: �S 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ GG r V O O 60 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES P410 <br /> ASSOCIATED BUILDING PERMIT#(if applicable):/ <br /> DESCRIPTION OF WORK: revn0ale( vwc bediboyvt, <br /> Q MAtAjf.. Al f 1( P, heAlleA10 v <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: l2o...c 'pc <br /> pr'c ^�6 <br /> CONTRACTOR ADDRESS: STREET / 75 !37 1-k q �/ <br /> CITYG /` d4rae STATE t4'4 ZIP -!rc'72, <br /> CONTRACTOR PHONE: 92-5 2- i' f CONTRACTOR EMAIL: Lf-r.."164,10pc-C-2G, Cool ff <br /> CONTRACTOR LIC.#REQUIRED: �,2 j'✓l #(REQUIRED): <br /> ( ) �%�C�f^ ,�., � �J CITY OF EVERETT BUSINESS LIC.#REQUIRE <br /> PRIMARY CONTACT: 0 OWNER ("CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: L/25- y2 ituei <br /> 5c�-4 o✓- C 5 CONTACT EMAIL: bce,y /pz - . COL,/ <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 /> —1 / E 1-) Og, Io3 <br /> Owner/Authorized gent Signature Date (Revised 9/23/2016) <br />