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ELECTRICAL PERMIT APPLICATION <br /> 0s►' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT-SITE INFORMATION ' <br /> PROJECT ADDRESS: 5 - <br /> s u� J.Id 5 <br /> BUILDING AREA(if residential,new con ction,remodel,or addition) i 5 p1 SF <br /> BUILDING TYPE: 0 SFR-DETACHED ,IirSFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$7, 234 <br /> NUMBER OF DEVICES(If low.voltage): <br /> FIRE ALARM? YES 0 NO <br /> ASSOCIATED'BUILDING PERMIT#:(if applicable): <br /> DESCRIPTION OF WORK: <br /> ttu 1Ot APA? SFS <br /> ]`_1 (1/44.-- L, CONTACT,INFORMATION <br /> OWNER NAME: C1TG TENANT NAME(If Commercial); <br /> OWNER MAILING ADDRESS: STREET 21300 Vi G $LUI 5TE /00 <br /> CITY V V boll rtd 1,I'r STATE CA ZIP q I 67 <br /> OWNER PHONE: -__ OWNER EMAIL: <br /> CONTRACTOR.NAME:bV&T Fi: (,, -IA( <br /> CONTRACTORADDRESS: STREET TO ," "'7U g <br /> Pj - 7 <br /> CITY OM. <br /> STATE WA _ ZIP 'Q4'042 <br /> CONTRACTOR PHONE:en3'(3I 7^1SOX CM CONTRACTOR EMAIL: petyytilfsepybvidirti-DlebtriG.YLer <br /> . <br /> CONTRACTOR LIC.:#(REQUIRED): '1 0l)El 3. 3C... CITY OF EVERETT BUSINESS LIC.:#(REQUIRED):cjq 337,1 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 51 i�vt�yr� C.Ii CONTACT PHONE: ZS3=19 •Trrok l Z g. <br /> CONTACT EMAIL Otont ro/lfi 41,444-rik I't,el <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> icitifYir\_.„-- LI .... <br /> I$x1 <br /> 1 E ( 70 `f 131.(_ <br /> Owner/Authorized Agent Signature Date (Revised 9723/2016) <br />