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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> miligy <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> : - PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 75 0( (-116,4Z.1)t.50 N 1> / ,,,,rcra-r6.---r7- / ut.,11- <br /> BUILDING AREA(if residential,new construction,remodel,or addition) /201 90.0 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: EKOMMERCIAL <br /> USE OF BUILDING: F(6,5E-K. 5g/PP/140-//z-c-c <br /> ELECTRICAL APPLICATION APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2A, (6. ((Cy <br /> / <br /> NUMBER OF DEVICES(if low voltage):< lee 2-0 3 <br /> FIRE ALARM? 0 YES Rrg0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): - <br /> DESCRIPTION OF WORK: Ze-co vet-,1444E. e ctz,“AL r-reA2 weR/t-10- <br /> - - CONTACT INFORMATION - (---- - <br /> ----- <br /> OWNER NAME: TENANT NAME(If Com ercial): "--FL-0).e3..( <br /> OWNER MAILING ADDRESS: STREET <br /> CITY , STATE P <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: /NM)11 1-4-C- <br /> CONTRACTOR ADDRESS: STREET ii 3 3 lb V r-4 S r S t-t) 5 7---(r. 2.d ) <br /> erre .2 se/.//44.1.006 STATE 44./74- ZP ?Sd0 s-7 <br /> CONTRACTOR PHONE: 266-35-t4-Z- CONTRACTOR EMAIL: ni i rei4. R&//v N 0 SI C <br /> CONTRACTOR LIC.#(REQUIRED): I I-04 DY L .g 7-3,(< CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5 7-15-0-0 <br /> ...____ <br /> PRIMARY CONTACT: 0 OWNER COCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Zi - 5 -'/- 27- 7--7 <br /> dr 7- e-f Zn-I-C<Ist Ctr-deaW,--i2 CONTACT EMAIL: ,.//6 7f. ,4::: . 44,0 0 //Zia, .ed-z-4- <br /> ... <br /> AGREEMENT:Thereby 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 <br /> type 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 /> FEE <br /> ..Aleggippor 777d/ . <br /> PERMIT# <br /> Owner/—. orized Agent Signature ---- Date (Revised 10/12/2015) <br /> • <br />