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–� !LECTRICAL 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: 7(2 vu- t"VYhOVe A V-e V\f I'f V I�2-0I <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED -ERFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: C� vi Ls-pQ( <br /> .... i his. F ......:. ..> ... ...i. : !,...`�``i.. ?: ., r:� ...,,, <br /> CONTRACT PRICE OF WORK: $ (g(e 0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES JNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ( Ot Inn V✓ ) CA(-W(1 ( Tov ,Iv, 17 l l�i f <br /> OWNER NAME: V 6tI4CA O &1 rotUd TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 7 <br /> (2We lOVC <br /> CING/ 4.1- e STATE wA zIP01%L0 <br /> I <br /> OWNER PHONE:r`2"✓ '✓ I( OWNER EMAIL: N 41- <br /> CONTRACTOR NAME: In et o(45e <br /> CONTRACTOR ADDRESS: STREET Iy�I D CIN ✓1, l,1 t f/VIw <br /> S STATE 11- <br /> 1- ZIP .9/9 - <br /> 2J// <br /> 9 2 <br /> CONTRACTOR PHONE: -1-107(. H- 12 CONTRACTOR EMAIL: I 0 - , I fS C� Q( GL/['C�0 <br /> CONTRACTOR LIC.#(REQUIRED) /, V 014 y>s C 52 Q G-7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): C / j <br /> PRIMARY CONTACT: 0 OWNER ra73ONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 1 js CONTACT PHONE:, 32. <br /> CONTACT EMAIL: tr, / / i Tu l ? It/r/. <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of la 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 /> ; A <br /> City of Everett Official Use Only <br /> �� PERMIT# <br /> Own: /Authorized A lent Signature Date (Revised 9/23/2016) <br />