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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 j www.everettwa.gov/permits <br /> l',9110jECtlitte INFO -10,4 <br /> PROJECT ADDRESS: : s if • fi . a ` �..t <br /> BUILDING AREA(If residential,new construction,remodel,or addltlor:)„ 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: $ cD Y°" <br /> NUMBER OF DEVICES if low vol= 'e <br /> FIRE ALARM? 0 YES NQ <br /> ASSOCIATED BUILDING PERMIT# if a .licable <br /> ,-_DESCRIPTION x .,_._. :. <br /> OWNER NAME: j TNANT NAME If Commertlrltl; <br /> OWNER MAILING ADDRESS: STREET >tlen ? x�l+ � <br /> CITY ,.kms .._ _ STATE" ZIP 6 •" <br /> p <br /> 1/22 30 OWNER EMAIL: <br /> OWNER PHONE; •w <br /> CONTRACTOR NAME: K2-'ilT't'. <br /> CONTRACTOR ADDRESS: STREET 1415 >c)cri ' <br /> tit <br /> CITY _44444.4` ' STATE <br /> ZIP <br /> CONTRACTOR PHONE;' o~ <br /> Wold l' CONTRACTOR EMAIL: <br /> eisrrucroRile. if tUpR e) ip �� • <br /> coy OF>E�lERET1'BUSINESS LIC #(REDt7lR1)) <br /> gipe- <br /> PRIMARY CONTACT: 0 OWNER .,,CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: <br /> &dalQ CONTACT EMAIL. i ctarlr, <br /> AGREEMENT:l hereby certify that#have read and examined this application and know the same to be true and correct. All provisions of taws end 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 stale or <br /> local law regulating construction or the performance of construction. Thai 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 /> �^,�( /Q PERMIT# <br /> qw+oerlAutttarlxad Ageatunt '� •! t7 �LJC 1r ` <br /> gtieture Date <br /> (Revised 9/23/2016) <br />