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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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: )((0-1 �'�� n{� � + �` C (J- 3 5 cUrrNf\r a .S <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1.3.COMMERCIAL <br /> USE OF BUILDING: -����c� <br /> ELECTRICAL APPLICATION INFORMATION <br /> • D <br /> CONTRACT PRICE OF WORK: $ Z:JC3 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ANO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): (3/ .%u) "J <br /> DESCRIPTION OF WORK: � � L ��'T - o L_ c,W.. 0 f <br /> CONTACT INFORMATION <br /> OWNER NAME: .v.Th TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �)nS 'u� 93``c \�(2_ i c�$\J ')NC& <br /> CONTRACTOR ADDRESS: STREET ,V, 'YJD9, <br /> CITY vsL ..� STATE ZIP <br /> CONTRACTOR PHONE: `-1 2 CONTRACTOR EMAIL:.V_\30'k_Us�� <br /> CONTRACTOR LIC.#(REQUIRED):V(/�Sjii ( 1 \L\ ( CITY OF EVERETT BUSINESS LIC.#(REQUIRED):03C{`a� <br /> PRIMARY CONTACT: ( OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1 S . .S _ v2,S <br /> -k\) 1R ( CONTACT EMAIL:ZU V 14 rJ,j� (\O�,C V\e- <br /> AGREEMENT'I hereby certify that I have read and examined this application and know the same to be true and correct. All prohsions 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 /> PERMIT# <br /> (1-6/1 E <br /> ner/Authorized Agent Signature Date (Revised 9/23/2016) <br />