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ELECTRICAL PERMIT APPLICATION <br /> _, CITY OF EVERETT PERIVIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ( (E)everetteps t©x everettwa.gov I www.everettwa.gov/permits <br /> f :pry t'. '� saw lfa*Itj� _ le <br /> 0 i yM ' '''..1'-i,-',1Z:1 <br /> ,�.ter,,.- j <br /> PROJECT ADDRESS: ^.' 3 0 F -er / I-et <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF 75- <br /> BUILDING TYPE: INSFR-DETACHED E]SFR ATTACHED .D DUPLEX Q MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> 9 <br /> CONTRACT PRICE OF WORK:$ 44 , <br /> NUMBER OF DEVICES(if low voltage); c. <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: r ` -1.—...9-1-a..24--' n ei Cl1/""e, } G' L.e-v <br /> v f+, n. , tO T Si$#' **fi ! r r » <br /> OWNER NAME: .. 2 i TENANT NAME((If Commercial). Cy e 1 -« <br /> OWNER MAILING ADDRESS: STREET f'� ... - .�"'y l <br /> CITY ® GY 01 <br /> STA,� y ZIP )R- ,r®il* <br /> OWNER PHONE: TOWNER EMAIL: 3 e ccs-C.. t t } jC i. <br /> cozy) <br /> CONTRACTOR NAME: f 1 j - t +T- I' <br /> `)/ 7 z j <br /> CONTRACTOR ADDRESS: STREET <br /> CITY f st " F STATEkJaZP' j OIt,?'" f <br /> () <br /> CONTRACTOR PHONE: 6- -qCONTRACTOR EMAIL: j) L i,.Y 1 <br /> CONTRACTOR LIC.#(REQUIRED) f ' e 75` CITY OF EVERETT BUSINESS LIC.#(REQUIRED `? , <br /> PRIMARY CONTACT: Q OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:N CONTACT PHONE: r 's'- - t) ` <br /> il <br /> CONTACT EMAIL: G i, <br /> her1 <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be tate 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 taw 18.27 RCW and 258,200 WAC. <br /> City of Everett Official Use Only <br /> , 1"----**)o '"� PERMIT <br /> 1 Owner/Authorized Agent Si:nature Date (Revised 9/23/2016) <br />