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09/13/2016 2 : 24PH FAX 425 439 7996 Home Run Electric Lir Z0002/0002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-2578810 FAX 425-257-8857 (E<) everetteps@everettwa.gov www.everettwa.gov/permits <br /> al i. T".&ITE'�1�lERIVlA7`!'aM r . <br /> PROJECT ADDRESS: - ' <br /> BUILDING AREA(if residential,now cons(ruotlon, remadel,or addition) SF <br /> BUILDING TYPE: Q SFR-DETACHED d SFR-ATTACHED M DUPLEX ULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL. <br /> USE OF BUILDING: <br /> � 4 1 %o►L AA,p IC TI MIN t <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBED OF DEVICES if low voltage):,,, <br /> FIRE ALARM? 0 YESO <br /> ASSOCIATED BUILDING PERMIT If applicable): <br /> DESCRIPTION OF WORK: ayt Of AT�) A-. <br /> Art MCA rA 0 no U I <br /> C'DIJ '�`T I' lQ1111'�i�ON <br /> OWNER NAME: ` T T NAME If Commerclal : <br /> OWNER MAILING ADDRESS: STREET <br /> CINLv-L�hadaTAYE LkA ap <br /> OWNER PHONE: I.OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CIN STATE Yla <br /> CONTRACTOR PHONE;tAay <br /> nnq 11 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED : CITY O EVERETT BUS& ESS LIC.#REQUIRF,D): <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> (-,V�(I 10 f)ry�(tL CONTACT EMAIL: <br /> .dGRt EAIENT;7 horaby oortily Ihat t h8V0 road and ekemined this application and know the same to be true and correct. All provisions of laws and ordinances governing Ihls <br /> type of work wlll be completed whether speeffled herehi or not. The granting of a permlr does nol presume to give authority to violate or cancel tho provisions of arny other stato or <br /> local law regulating construction or the portorMenoo of construction, That l em authorized by the ownor of this properly to porfoml the work for which application is made and <br /> comply with the State Contractors Law 18.27 RCW and 286.200 WAC. <br /> City of Everett C'fflrlaf Use Only <br /> FEE <br /> 4 E 0C <br /> LL—"' <br /> PERMIT# 1 <br /> iar/Authorized Agent Blgn ure alp <br /> (RCvig(3d 90/12/201.xr <br /> ) <br />