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Jan 02 18 01:10p Ferrin Electric Inr 1 3377746 p.5 <br /> 14.677 <br /> ELECTRICAL PERMIT APPLICATION i <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE I l,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa-gov I wwnr.everettwa,govlpermlts <br /> P OEC T A1 INSO TE.. f.3 <br /> R31If TI.. <br /> PROJECT ADDRESS:1 9 AO 1 oi tY ...sr LC'1 J C' <br /> BUILDING AREA(if residential, new construction, remodel,or addition) ' ••%(51) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 'SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: Cl COMMERCIAL <br /> USE OF BUILDING: 0 NNi <br /> . 1 <br /> t <br /> • ECT APLC .O0ORAtON" f <br /> - <br /> CONTRACT PRICE OF WORK:$ 'J i O V ,1) <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? D YES D NO <br /> ASSOCIATED BUILDING PERMIT# if a licable: _ <br /> DESCRIPTION OF WORK: <br /> deA <br /> kCp <br /> .NTACT, NFOIftM � . .";,:T O N . .ti <br /> 1 <br /> OWNER NAME: Ng i j m.s ,,j-QA€;Qt LLLTENANT NAME If Commercial); <br /> OWNER MAILING ADDRESS: sirieer `Dy,y_0 'j W f.:\1/4-iiiIAA4i e , ,\J7 a/{ {t7u1 <br /> CRY EA/vV l ,�STATEV V ?7P" 4 j 'J xL`_# <br /> OWNER PHONE: Ii S. 41 G.3 ac(� OWNER EMAIL: [ 1 <br /> CONTRACTOR NAME: i•`4i,il if1 E2IA. Y:x 1 �,Il ,�J( <br /> CONTRACTOR ADDRESS: STREET ¶bQ , ) q s , <br /> CRY ' ' •'1, c'M4,;V1\ STATE t,\ ZIP fi4c0'" 1 i <br /> CONTRACTOR PHONE:Si)5? 33163%5 CONTRACTOR EMAIL .41��, c::(ff\y e,t ((41k GIN(, t' <br /> CONTRACTOR LIC.#(REQUIRED}: ' _(T y€„i 013 9 N C CITY OF EVERETT BUSINESS LIC. EQUIRED}: , 3C/1 L} f ! ? <br /> PRIMARY CONTACT: 32koWNER 0 CONTRACTOR 0 OTHER(Please Specify) 3 <br /> CONTACT NAME: CONTACT PHONE: 1-1-.„)6 S QS CAI t- I <br /> ' 1''�I �N'1r CONTACT EMAIL: A1fk I k 4) '�j. l fyy�Mei L'' ,.k-f lay)Ii.L;W1 f <br /> i <br /> AGREEMENT;1 herebycertlfy that I have read end examined this application end 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 pmvisions of any other stale or ! <br /> local law regulating construction or the performance of construction. That J am authorized by the owner of lids property to perform the Work For which application is made and I I <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC. r <br /> 1 <br /> 1 <br /> r <br /> N <br /> r\s....---' 0•—•-• • <br /> Cityof Everett Official Use Only <br /> i <br /> 1Il <br /> PERMIT# <br /> Q., � � ���� �013 <br /> Owner/Authorized ••••=nt Signature Date �(Revised9/2312018) h <br /> 1 <br />