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477 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 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2LA (_)-le Z c7\-2-1 cJ _ of,1ik <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: 0 COMMERCIAL <br /> USE OF BUILDING: S 1^j — LA-1 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): nn / �� 1 <br /> DESCRIPTION OF WORK: �Q(- ) > rA -tI) ck7- �t�v._ t ff!� Pa 'i,P <br /> S.Q e otKA-Iet-) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,2i S? f l fir 7 yr.` / (*c <br /> CONTRACTOR ADDRESS: STREET � lA <br /> OP c:;41.0 <br /> 1>t$X' '-1 - I <br /> ore ry�- \`;( I STATE A ll ZIP <br /> 2 <br /> CONTRACTOR PHONE: - - 3B— K/3 CONTRACTOR EMAIL: �wciSendCly."TAC. 0L; <br /> CONTRACTOR LIC.#(REQUIRED): 6- 0;0X SSe CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 1 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (.4):5--_ I jg <br /> (�n_`Q 3 Lo_t f CONTACT EMAIL: 5,41,4Q J� <br /> AGREEMENT:l 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 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 /> City of Everett Official Use Only <br /> '4r ,cit PERMIT# /V <br /> e / 7E is( 0— <br /> OwnerlA rized Agent Si •ture Date (Revised 9/23/2016) <br />