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ELECTRICAL PERMIT APPLICATION
<br /> - -,_ CITY OF EV RETT PERMIT. ERIK
<br /> 3200 CEDAR STREET, EVERET1%WA 98201
<br /> (P)425-257-8810 ,X -.257-.5857 1(E)ev retteps -ver ttwwa.gov I everettw .g vio rt it •
<br /> 4
<br /> yy��■yam' a: qJ
<br /> ^• R�iW11f ° . .0 ^ \.- }' iT5.
<br /> PROJECT ADDRESS: ell i \ �, :1-0,44A..,,,,..,,„ To,,° --9 92f)2 t9)41°St.-EkrO(''A*
<br /> BUILDING AREA(if residential,new constntcfion,.remodel,or addifktn) SF
<br /> BUILDING TYPE. ?CI SFR-DETACi O I S R.ATTACH D 0 DUPLEX 3 MULT.t•F.AMIL?;#=0F NITS 0 oC3tt M ntl i.
<br /> 115E OF Bt HLDf G: � .,
<br /> '', ...,' ,EL ECTIEiwit A :100 Tit N INF.-01-M A1TiC11i .-, ,,,,* ; . :::2;7:::!.7.
<br /> CONTRACT PRICE OF WORK:,$ i c, C . .
<br /> NUMBER.O DEVICES(if low voltage);
<br /> FIRE ALARM? C YES %NG#
<br /> ASSOCIATED BUILDING PERMIT t(if applicable): if
<br /> DESCRIPTION OF WORD: if 46 <i . rt 4, f t0 i L
<br /> v '5'8N
<br /> .qF N y� ,„1„,., °' ..LN.-?.-„,,,,,. Eo : T'l,mF *O$ g L vsggF4
<br /> OWNER NAME: �.. ' ( r 77' TENANT NAME(If Commercial): �e/7t./ i ' .,
<br /> OWNER MAILING ADDRESS: `kyr , v.r ' v .10 x-+ L"
<br /> airy 44: . " " TATE/1:00",: ZIP 417.0X0/
<br /> OWNER PHONE: A , C WNER EMAIL: /iL
<br /> 'CONTRACTOR NAME: t�> ' :, t- , r
<br /> CONTRACTOR ADi_
<br /> DRESS: 6 g s . ,�
<br /> J� oriN
<br /> CONTRACTOR PHONE: - ?$7� "ZJCONTRACTOR EMAIL; ,,, \t .L/ i s
<br /> CONTRACTOR LW.W(REOUIRED) S1(U [CITY OF EVERETT BUSINESS tit's.#REQUIRED): � `
<br /> PRIMARY CONTACT: E3 OWNER ONTRACTOR, ❑+OTHER(Please^Specify)
<br /> CONTACTNAME: CONTACT PHONE: g — 6
<br /> CONTACT EMAIL;
<br /> AGREE MENT t twreby k that 1 Piave read Irl examined Phis �.ar?dk
<br /> ftow tttesame to Ire .an coned Atf WWs 1s cif i dd ancesgavernm type
<br /> o/ rrtr`wflt he natrtpieted whether sped harem of not, The orentkaretsporetitrionattet tatteentetrtpitnattotity to violate or canoe l tt a vIs1ons:ote ry attar Ste t
<br /> local law:regulating construction or the portorinance et constwction 'that Lamauthorzed 6y theowner of this fN party to perform the work for which appfication 1s made:arid t
<br /> fly with the State Contractors taw 18,2711CW and 296.20 i?lfA
<br /> Cityof Evmf tt Cattet'Use only
<br /> PERMIT
<br /> ..... .. ,..,4,-- ... ,..:. .. /...... .., . ...<.:. . ,, ,,t) 7. . . ii#7_ /i r. Et(?)()1-1,66
<br /> Ownptilluthori:rod Agent Signature' Dee /Revised9123/2016)
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