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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 /> i R lJ ' '',-$11E7'.-,- ;' M '1 oui <br /> PROJECT ADDRESS:- <br /> BUILDING AREA(If residential,new oor1 trust on,remodel,or addition) . . <br /> SP <br /> C0 <br /> BUILDING TYPE. 'g +FR-DETACHED x ATTACHED f?t__ <br /> _X 0 M ILTf-FAUI1k Y-#OF UN(T- <br /> 0 41�4t' RC(,4� <br /> USE OF BUILDtN x-, <br /> ., ,t % l E Rtd4 < I 1 At a$ F tKIn <br /> CONTRACT PRICE OF WORK $ ` <br /> NUMBER OF DEVICES lt low voit. <br /> kFIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# it"aii.'i,fi ible;x <br /> ..._... <br /> OWNER NAME: 4R1 <br /> '` •" r. [ "" TENANT NAME If Comma-1'40 . <br /> OtqueR MAILING ADDRESS. arae t- <br /> --- .(17watt W.. <br /> OWNER;PHONE ZQ <br /> 0 0 "i • <Oja' OWNER EMAIL. <br /> CONTRACTOR NAME: A <br /> f <br /> CONTRACTOR ADDRESS: 3r2E1r <br /> carr .. *4e; <br /> ilti <br /> f"I - C`OR PHONE; , CONTRACTOR EMAIL:, 40 ' ' d''m. ° <br /> • �` � aUtFtE �m��° P �� �. «�. or'''A �" e:VN <br /> O EVERETT BUSINESS LIC.IRREOUIP _ 'rill __,, <br /> iit1MA1�CA#YfiA�.. T C3y+l rm; CONTRACTOR El OTHER(Pleast}Specify) <br /> CONTACT NAME: <br /> ONTAAT PHONE <br /> �n <br /> I u `e CONTACT EMAIL:. .: <br /> AGREEMENT:I hereby certify that have read and examined this application and know the same to betrite and correct Alt provisions ofta�wa end ordinances nances govemin lhrs <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 end I ype <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> (o « tb ' E t Z(Q� Q� <br /> owner'f.Attfhorki.Agent signatti. ' <br /> L`ste.:_ <br /> (Revised 9123/2016) <br />