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sp. 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; !Si <br /> BUILDING'AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE.LX.SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX 0 MULTI-FAMILY-#OF UNITS,. 0 COMMERCIAL <br /> USE OF BUILDING; <br /> 5i°• Ig'2''"� t,4��•wyat a m 4*.:'.4 <br /> X,y r E 7 _.. <br /> CONTRACT PRICE OF WORK: $ 9-50 ,c'' <br /> NUMBEROF DEVICES if low vo(t:•i t <br /> FIRE ALARM? Q YES te, {} <br /> ASSOCIATED BUILDING PERMIT,#-ifayalleable' <br /> t OR - to, m, a lor s• . .w ,Awlk A. t ~ -r _ . <br /> DINNER 1,,it ,r Ot TENANT NAME tit Cat tietotet):. <br /> OWNER MAILING ADDRESS: STREET II CaIli f- <br /> t) <br /> city r� .e g v <br /> � .. .. .� ZIP 'g � . <br /> OWNER PHONE ' „ (• 3 <br /> OWNER EMAIL <br /> CONTRACTOR NAME: LtS <br /> CONTRACTOR ADDRESS: srREET ' 1 I- D e , <br /> onv g 41 <br /> k1; 20 <br /> DiDNTRACTO.R PHONE: 1 05CONTRACTOR EMAIL: '0, 4�"�" <br /> r t <br /> CI ® .E.tRETTBUSINtSSLIC.; (i Ot11RED. [ sr i1"�io, - <br /> PRIMARY CONTACT: 0 OWNER r CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 5 51 U <br /> " t) <br /> � .CONTACT-EMAIL: C " <br /> AGREEMENT:t hereby certify theft have reed end examined this application and know the same to be(rue end 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 gwe authority to violate or cancel the provisions of any other state or <br /> iota)law regulating construction or the performance of constmction. Thal I am authorized by the owner of this property to perform the work for which application Is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC, <br /> City of Everett Official Use Only <br /> PERMIT# <br /> k 5• .i g E S -D <br /> Owner/Authertzed.Agent'Signature Date <br /> (Revised 9/23/2016) <br />