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ILECTRICL PERMIT AldilLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-88571 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:0 g Z( // 11U-e ,rj—. <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: L'i't✓OMMERCIAL <br /> USE OF BUILDING: (;/)mv\ Ov • <br /> ELECTR <br /> t;o L APPLICATION (INFORMATION <br /> CONTRACT PRICE OF W'• : $ se <br /> NUMBER OF DEVICES(if Iw voltage): 1�� <br /> FIRE ALARM? 0 YE". M'M• <br /> ASSOCIATED BUILDING PERMI : .if applicable): <br /> DESCRIPTION OF WORK: 1r��,�e�-C ��c' Lt—/ (evil¢z-e>)e`' o / ..9 't // <br /> • <br /> CONTACT INFORMATION . ... <br /> OWNER NAME: TENANT NAME(If Commercial): 6 //2,•01 <br /> OWNER MAILING ADDRESS: STREET <br /> CIN STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: L' j�Cv r O17( 4j /Jet,/ <br /> 1 �J <br /> CONTRACTOR ADDRESS: STREET /b(O 7 Sarl ti v • Tiezevue,W i �C� <br /> / STATE OA__ ZIP <br /> CONTRACTOR PHONE:,)3" 57a- 3 ZZ CONTRACTOR EMAIL: • <br /> CONTRACTOR LIC.#(REQUIRED),YJ��� C. f7j�JG CITYOF EVERETTBUSINESSLIC #(REQUIRED;O�S3 2 r <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:(` �-/, _ ,� CONTACT PHONE: 2S g o L/2$ -g(r)L, <br /> CONTACT EMAIL: <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type 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 lam 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 /> City of Everett Official Use Only <br /> FEE <br /> , ..441111P �- PERMIT#E ._. <br /> 7--051 <br /> %'" /Authorized Age• Signa "re Date (Revised 10/12/2015) <br />