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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 E FAX 425-257-8857 t (E)everetteps a@everettwa.gov l www.everettwa.gov/permits <br /> PROJECT SIT <br /> PROJECT ADDRESS: <br /> BUILDING AREA fir residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: FSPR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-if OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ' ELEcT cA'' • CATf , i ,itittiv)AVIOti <br /> CONTRACT PRICE OF WORK: $ <br /> 00 <br /> NUMBER OF DEVICES Of low volt � <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# If apalicable <br /> ..DESC TIO. .-.OEWORk . <br /> OWNER NAME: ik ALL # •` ' s A. TENANT NAME IrOcur+merclt l <br /> OWNER MAILING ADDRESS: STREET `P i <br /> cmr '5 ,, W <br /> Q. <br /> !""y �"��.,-.., gT4TE ZIP �TJ � <br /> OWNER PHONE: Las C' . OWNER EMAIL: <br /> CONTRACTOR NAME: V. <br /> CONTRACTOR ADDRESS: 3TRFF..T I. W <br /> CITY 4.4 w r� ST ZIP <br /> 242 <br /> CONTRACTOR PHONE: '°s <br /> •�•..1� � �� CONTRACTOR EMAIL .�A��-'" / � �1[' # `1.1114 <br /> CITY EVERETT BUSINESS LIC E'E6 ikiR Et7 <br /> PRIMARY CONTACT: 0 OWNER ,`4; coNTRAcToR oTHER(please specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: a5 R5CI D'5aO <br /> ie C NTACTeEMAIL:, * <br /> AGREof workEMENwiltL I hereby certify that(have read and examined this application end know the same to be true and Correct. Alt provisions of laws and ordinances governing this type <br /> be completed whether specified herein or not. The granting of a permit does not presume to give authorfly to violate or cancel the provisions of any other slate or <br /> local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> (�' PERMITt # <br /> OwnarlAuthotlxeb)2gent gnatur8 �' '� . .+•: E \ "� 0 32 <br /> Date (Revised 9/23/2016) <br />