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Jan 02 18 01:08p Ferrin Electric Inc 4253377746 p.3 <br /> OLT <br /> 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 /> ............ <br /> . <br /> i) .E SITE i1 te <br /> PROJECT ADDRESS: 9 .t4.- \ 9-11-, 1C- Q L c j <br /> BUILDING AREA(if residential, new construction,remodel,or addition) .14.0S c SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED D DUPLEX 1:71 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: —T�N..R\ t,'�t'rvi <br /> iELECCTRICAL;;t P-PLACATION INFORMATIO l,: <br /> • CONTRACT PRICE OF WORK:$ )i GO J ,ii <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? Q YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: r,sf \iNk. AL\-:', 4 Or' 11(7.0 '\,1 <br /> ,. .i...COI�ITACT:' N MA ON! <br /> ,.il �t <br /> � ....:.e........ ...: e:kW0%. ....,,.. is•..... . ... <br /> OWNER NAIVIE: Nsz-)NoNst l p 1 S bia.At; 't'4r1 _TENANT NAME(If Commercial): • <br /> OWNER MAILING ADDRESS: sneer J 0 ESN V\''\ l Ii\ti\ <br /> CITY. Eti+'ry�, SiATE\A)A 9PCS Viii <br /> OWNER PHONE: t• ',5 Oq 1 G3 <- OD OWNER EMAIL: 1 <br /> 1, <br /> �', <br /> CONTRACTOR NAME: c�i Nt l CV- <br /> -1 <br /> CONTRACTOR ADDRESS: STREET¶ O , Q)0 <br /> ) , 1 �(1; j_[t . <br /> COY ! tiS1)_ 04. k STATE Y• L zwP 8041 <br /> CONTRACTOR PHONE:H-As '33 i 5 CONTRACTOR EMAIL s`��(C cif i �>r%e i,t-4a(,•<4y1t ,'�,.Irvyo <br /> q�r <br /> r CITY OFJEVERETT BUSINESS LIC.#�(REQUIRED):�, JG}et <br /> CONTRACTOR LIC.#(REQUIREDy: �� {��' ����3� �•� <br /> .. .......... .. ..... ... -:. ...... .. .... ... . ......, .. . 111 <br /> PRIMARY CONTACT: OWNER 0 CONTRACTOR ❑OTHER(Please Speoifg) <br /> CONTACT NAME: CONTACT PHONE; S a at' l 1 <br /> f. <br /> �t\n e1' Y- [ I-CONTACT EMAIL: AI 4)4i.d1f Olt.Le•i 4( C.i1 (..1.(N t` <br /> AGR,REMENT:I hereby certify that t have read end examined this epp'ication and know the same to be tree end correct. All provisions of laws end ordinances governing this type ) <br /> of work will be completed wheTerspecifed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stale or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work Tor which app,Ycation is made and! <br /> comply with the Stale Contractors Law 113.27 RCWand 296.200 WAC. , <br /> N <br /> r, <br /> c <br /> .r\-... <br /> i City of Everett Official Use Only I <br /> 0 �� ` � PERMIT# <br /> 1lElq)01- 6n <br /> —� <br /> Owner/Authorized • ,ant Signature Date (Revised 9/23/2015) <br /> N <br />