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O <br /> W- ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps©everettwa.gov( www.everettwa.gov/permits <br /> ._., pROJECT SI 0 s <br /> (� <br /> PROJECT ADDRESS: z .`.�..,. <br /> � C'�,��.�d <br /> BUILDING AREA Of residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS _ 0 COMMERCIAL <br /> USE OF BUILDING: <br /> CONTRACT PRICE OF WORK: $ °c• <br /> NUMBER OF DEVICES If low vottae)r <br /> FIRE ALARM? ES 0 NO <br /> ASSOCIATED BUILDING PERMIT.# If at alleable;, <br /> DESCRIPTION ?F WORK: 670/ m.,. ' -- <br /> & "I <br /> OWNER NAME <br /> Oil "O, TENANT NAME f Commercial): <br /> OWNER MAILING ADDRESS: STREET /, 'p r , <br /> CITY_.. Otte.)) <br /> STATE LL2 08824 <br /> OWNER PHONE f <br /> .. +�I� � �0ltJiYUNER EMAIL: <br /> CONTRACTOR NAMEt v�2� <br /> CONTRACTOR ADDRESS: �STREET N <br /> -.. ET %ALA .: <br /> CITY ce_t""c STATE - <br /> CONTRACTOR PHONE: litgY 36q 5-6` . )CONTRACTOR EMAIL; dekelivie ► , tool <br /> ...._CO.N t f AACTQR Cfi�#j 'o c5-i {rr Y <br /> CITY OF EVERETT BUSINESS LIC (3DU)RED)4 <br /> PRIMARY CONTACT: 0 OWNER fekCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CRs 9-56/ a <br /> Ie CONTACT EMAIL - t <br /> 1 AGREF.kf��J�` it Vetted, �� <br /> hereby csf!that I have read end 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 Coropteted 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 t am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> y )2paAtik, E SO2 -033 <br /> OwnetfAuthorized Agent titgneture; <br /> Date (Revised 9/23/2016) <br />