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ELECTRICAL T & FIRE ALARM P IT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 08201 <br /> )425-257-8810 1 FAX 428-257-8867 1 ever . . ,z erettwa,gov} www,everettwagovIpennas <br /> PROJECT Sit` . TIOPI <br /> PROJECT ADDRESS: 7209 7th DR W EVerSit WA 98203 <br /> el2td)JECT TYPE: ®NEW CONSTRUC11ON C]ADDITION 0 TENANT IMPROVMENT a REMODEL. <br /> BUILDING USE: El SFR C]TOWNHOUSE C DUPLEX ®ADO CI MULTI-FAMILY-#OF UNITS: l .. CI COMMERCIAL <br /> BUILDRIG AREk 9Sq ft <br /> ELECTRICALELEcTRICAL APPLIcATIONLNF RMATIt•ti <br /> coormkoT ISE OF WORK: ASSOCIATED BUILDING PERMIT$( applicable);,.,.. <br /> IS THIS LOW VOLTAGE WORK? C NO 0 YES-#OF DEVICES <br /> IS THIS A FIRE.ALARM PERMIT? CI NO C3 YES-FMS required r review(Both Electrical and Fire Department insptions are required) <br /> DE*CR ii)ft or WORK A,,40011 CORSRLERMCM. <br /> DESCRIPTION OF WORK: r ve 2 exterior fights to a&regent,already existing,switch. <br /> THIS SECTION APPLIES TOALL.E IM SI to H ALTh r. R PERSONAL CARE FAC <br /> ri By-checking it,loot statingthat 1have read and understand a6 of W 296-40314($1,salected**specific reason on page 2 <br /> tomi of tisPagen(See. . . NOT ' I to `itg drat donot <br /> 2See require Plana .�; <br /> ATTENTION t l+ lit TMS SECTION 15 FOR;OWNERS PERFORMING WORKAS THE CONTRACTOR WITHOUT ELECTRICALLI CENSt E <br /> ri Pursuant to R6 10.282 61,property owners and leaseholders cannc4.perform electrical work on bui for rent, or lease without <br /> 1 the proper electrical licensing and certification,or exemption.By checking this box,I am Ming that I have completed and signed the <br /> seep ,e3 AFFIDAVIT page 3 of this application to receive exemption from this Iicensing/ce tion requirement. <br /> CONTACT i FO 'IA"IONt <br /> OWNER NAME: , rn"c TENANT NIf Corrrrrr rcial <br /> OWNER typutINE MALIADDRE ; sTREET 7209"lib DR W <br /> vem0 FATE 9 203 <br /> CITYOWNER PHONE; /tea '4263 IovvNER EMAIL: i:rsoni. v ; %ait.sora <br /> CONTRACTOR n <br /> CONTRACTOR ADDRESS: SUMO' <br /> crry STATE 21w <br /> ,cONTRitel PRONE: CONTRACTOR EMAIL: <br /> C I` O): crrY oF EVERETT Bt VIR ) <br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR 0 OMER( 3: .:Spm) <br /> CONTACT NAME: t TACT PHONE: <br /> CONTACT EMAIL: <br /> AuREEHENt t by certify that!have read end exrrinedthis application end know the same to he and coned., Mori:vitiate of Jews ottitoenoes <br /> governing this:typeta work wit/be mp,;eted.whether speorferd herein or not r;grentr eta permit not presume togiveaut tee violate or canoe)the <br /> pmuteiens oferiyc other state `local,fawregu Gonstrucdrtnorthe per n ofor zwc i, 1ate authorized by the owner of this rty to pertonn <br /> kterk for which eoplication is made and I h the State Contactors.l /8.27 vv-sod 296200 WAC; <br /> City of Everett Official Use Only <br /> PERMIT <br /> 11 OI1 �I'1 <br /> . r vised f' 18) Page i of 3 w. <br />