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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 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 7O /0 oa . <br /> t <br /> BUILDING AREA(if residential,new construction,bode addition) SF / 41 , thP , <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: e p4 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 7O0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ,I NO <br /> ASSOCIATED BUILDING PERMIT#(If applicable): WI- <br /> DESCRIPTION OF WORK: // t a J r " e-6 l`'.'9t72p?e,,A7 (-/ -1 ,:yiOa k ° ie <br /> a + 1 <br /> CONTACT INFORMATION <br /> OWNER NAME: eveRett- Ajar s L TENANT NAME(If Commercial)• , b 75e d <br /> IR <br /> OWNER MAILING ADDRESS: STREET 56a.„,. el/Vernal-it <br /> CITY _. STATE '73 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET 7575 f- / ,ate l� <br /> CITY /04-49/N STATE✓1J/1 ZIP�`�3�./ <br /> CONTRACTOR PHONI : ) Z ?- 5753 CONTRACTOR EMAIL: L ori) t#p.c <br /> CONTRACTOR LIC.#(REQUIRED): € - <70O LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0,3O 5 <br /> PRIMARY CONTACT: 0 OWNER , CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:f/Yt 1 — CONTACT PHONE:N:9) 9 '`4J <br /> + r y SCh\ 01' CONTACT EMAIL: iW ' .,Y „seafJ <br /> AGREEMENT:1 hereby certify hat 1 have read and examined this application and know the sameY)delve and correct. All provisos 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> fi <br /> . �l � PERMIT# <br /> ,ter <br /> E ��� o - �� g ci) <br /> rf uthwlzed Agent SignatGre } Date (Revised 9123!2016) <br />