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E�CTRICAL PERMIT AP�ICATION <br /> CITY OF EVERETTPERMIT SERVICES <br /> 320Q CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits <br /> _ = - - RR�EC�'-�lT�INFt�R�-'�'�ON-- _ - -_ - - <br /> ___ �� _ ��._ . � � -- <br /> PROJECT ADDRESS: l' Gl �—. `�"h � c^� (��j � <br /> BUILDING AREA(if residential, new construction, remodei,or addition) -- SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: -�jrQ <br /> ELEGTRt�AL lkPP44CATiQ�1 INF4RIYli►TIQN = - <br /> - <br /> _.. . _ . . _ <br /> CONTRACT PRICE OF WORK:$ /���,"�' <br /> NUMBER OF DEVICES if low volta e): <br /> FIRE ALARM? ❑YES O <br /> ASSOCIATED BUILDING PERMIT#(if a plicable): <br /> DESCRIPTION OF WORK: � �� - ; � �` ` (� ( <br /> � <br /> r � h�r r` <br /> , <br /> . <br /> �.< � ; <br /> ' > -° , ' u �41�T#'�C71NF�I�MA"�`i�N ' <br /> OWNER NAME: L...,N �. L� TENANT NAME(If Commercial): � <br /> OWNER MAILING ADDRESS: sTRee-r -- r `�' <br /> CITY ��,� STATE L.��' ZIP <br /> OWNER PHONE: �- OWNER EMAIL: <br /> CONTRACTOR NAME: CY' E�i ��G. �I� N C.P_CJ`�'Y'�� �'_ Q. <br /> CONTRACTOR ADDRESS: srReEr � Yj — � �/� , � � <br /> CITY L /l.�� C�-��-� C3 �i STATE � ZIP G�O�l�j <br /> CONTRACTOR PHONE: - — Qp CONTRACTOR EMAIL: YY�1rL(�GTr�� � L� ,' <br /> CONTRACTOR LIC.#(REQUIRED): =(- �, CITY OF EVERETT BUSINESS LIC.#(REGIUIRED):�J�/.,� � n7 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: �G n�Q. (�bvS CONTACT PHONE: — _ _ <br /> C7 <br /> CONTACT EMAIL:r.n � � � <br /> AGREEMENT.�I hereby certify that!have read and examined this appticafion and know the same to be true and correct. All provisions of laws and ordinances goveming this type�o cr� <br /> of work wilt be comp/eted whether specifred herein or not. The granting of a permit does not presume to give authority to violate or cance!the provisions of any other state or <br /> loca/law regutating construction or the performance of construction. Thaf 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 Officia/Use Only <br /> PERMIT# <br /> _ 0, - 1� E ��lll - eo� <br /> OwneNAuthorized Agent Signature Date (Revised 9/23/2016) <br />