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Jan 02 18 01:08p Ferrin Electric Inc 4253377746 p.4 <br /> I <br /> 3 <br /> 141577 . ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 1 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everettops@everettwa.gov I www.everettwa.govlpermits ' <br /> ... . _.. t.: ..'... ...... ._...........:.... ._ .: ....>PROJ.EG� .�.,5 TE.1 �O ATItiN�' <br /> .T. 1 <br /> R <br /> F: N - <br /> PROJECT ADDRESS: —1 9 T 19-1177-7, . L(4 E S <br /> BUILDING AREA(if residential, new construction,remodel,or addition) :a.%VC SF € <br /> I <br /> BUILDING TYPE: 0 SFR-DETACHED XSFR-ATTACHED 0 DUPLi✓X D MULTI-FAMILY-#OF UNETS: 0 COMMERCIAL <br /> USE OF BUILDING: --1-0i . <br /> I <br /> r� <br /> x.• <br /> k - <br /> ECT GA T� EOR A .l� <br /> - :1E L: `PPL CA -T[��1 ON= <br /> A 1 4 N <br /> • CONTRACT PRICE OF WORK:$ 1_i t)1) ,DI <br /> NUMBER OF DEVICES (if low voltage): <br /> 0 <br /> FIRE ALARM? D YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# if a linable: <br /> DESCRIPTION OF WORK: VV.,\, t —VGrOrN \'1Lp ' } <br /> i <br /> i <br /> :.:...: ... ....�:=. ,..GON� : CT, FO M , :Ifl <br /> y.. <br /> A N N.:. . <br /> OWNER NAME: 1 1 A `k.1 Ac J4Q,�k 'LI..L.TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 0 YV €JWP/ ,'\ik/l1 <br /> my } <br /> Y L:� STATE\A A ap' �� �} <br /> OWNER PRONE: I'i c)'.6 al,63 a I. OWNER EMAIL: ]]] <br /> CONTRACTOR NAME: '1,:-14 \T1 Ej (..4nr. ( f <br /> CONTRACTOR ADDRESS: STREET ! 0 , Y)0) MAA j�tr {[- <br /> CIN 1')r , ,�� STATE \i p t'\ { f ZIP 4 Yr) .X - <br /> CONTRACTOR PHONE:M.)5-33) E&mob. !CONTRACTOR EMAIL i�r ��I, Cfr,�P, .t �, (I Ci n <br /> CONTRACTOR LIG.#(REQUIRED): a CITY OF EVERETT BUSINESS LIC,#(REQUIRED):053 a/ 4, <br /> PRIMARY CONTACT,' XOVVNER 0 CONTRACTOR 0 OTHER(Please Specify) s <br /> CONTACT NAME: CONTACT PHONE: 4,x5; S l.'q ar i t. 5 <br /> " <br /> > \V\Yti Y1 CONTACT EMAIL: AIr1,1t\ ry toY,fi t iti -1 ILM t.,,L(Agri k <br /> AGREEMENT:I hereby certify that I have reed and examined this application and know the same fa be true and correct. All provisions of laws and ordinances governing lhis type l <br /> of work will be completed whether specified herein or no/. The granting ore permit does not presume to give authority to violate or cancel the provisions of any other state or u <br /> Foca(lawregulaitng construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and I i <br /> comply with the Slate Contractors Law 18.27 RCWand 298.200 MC. J,; <br /> N <br /> City of Everett Ohrola!Use Only <br /> I <br /> ' ` PEMIT#! P <br /> 0. ---_ 17� EIS6ID12 <br /> dll <br /> Owner/Authorized • •-nt Signature Date (Revised 9/23/2018) <br /> ,9 <br /> i <br />