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--- 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 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: , V ' ` ar P1 <br /> BUILDING AREA(If 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 /> tt , <br /> u n <br /> CONTRACT PRICE OF WORK $ <br /> - f <br /> 10 <br /> NUMBER OF DEVICES(`tf low voltage), <br /> FIRE ALARM? DYES *O <br /> ASSOCIATED BUILDING PERMIT# If a,.licable <br /> ...Y- <br /> von <br /> y <br /> in <br /> OVYNI:F NAMEaj'il TENANT NAME,(If Commerclt . <br /> OWNR.MAILING ADDRESS:: STREET t7� j P <br /> OWNER PHONE. ii. .5 43t `' - OWNER EMAIL: <br /> _ . <br /> CONTRACTOR NAME: < ' A 9.:.m. *ri <br /> CONTRACTOR ADDRESS: STREET5 laroctclt,u<at <br /> CITY f <br /> STATE 1 ZIP •?0# <br /> CONTRACTOR PHONE: <br /> .4. ... 0,-, ta CONTRACTOR EMAIL: 0, *.,0 $9. '. ,i** .o'��1;If if. ;r m 17'1 <br /> y. e-<04 P::(NEQUIRED t I l'T r *111r CITY OF EvERErr BUSINESS LIC,.' RE-Qum) s• 0 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: .a6 q, DeTy6 <br /> i , CONTACT EMAIL: d, ' iticati corn <br /> '''''? <br /> AGREEMENT I hereby certify that f have read and examined this application and know the same to be true end correct. All provisions of le-Ws 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 Oficial Use Only <br /> PERMIT# <br /> ,12 "` <br /> Own!r/Atitltorizod„Agent Monature Date <br /> (Revised 9/23/2016) <br />