|
05/06/2016 11: 13 4254897996 HOME RUN ELECTRIC PAGE 02/02
<br /> ... ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits
<br /> y;!' di li I;8s,.';Is : s; .i ;;I,iy, 1 r" x a su, m lfi _ t s 1 :ii4'I1.{d1�1�{tmollilti:i 9
<br /> f i31,�'E( II i i, i. }} Ir::�.'sii W ii I lf�ir,F $m i „ I ) f W 41�■} ,., ," 1 t .. { 1 i i ii Ill c :c..:.�ii 7)(jl Itl:;,li ,it ,f.1 1 h�ial.: 13
<br /> I , , „I 1 . �1 f f.,. Ii ,,I:,r { I I l ,. 'N' 1 { I = 1 .: l, ,.f: f l Erni ,, .i,r, air,
<br /> �v=,�s•r�i 61.dS!€�=;f R Eu,�,.�,��.�ll,i1,,14 ..,F,tu al ��i i:,>:,.,,,,, .I'..t II � r
<br /> PROJECT ADDRESS; ,C' EP 6 �— . r c `e. S
<br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF
<br /> BUILDING TYPE: El SFR-DETACHED CI SFR-ATTACHED 0 DUPLEX El MULTI-FAMILY-#OF UNITS: �J�OMMERCIAL
<br /> USE OF BUILDING: ((Lr C -1-\(-N ,7 � }j- � C (�t.54- ��// .
<br /> ".:s:r;�v Tari=r tt 1,"i'_;. ' f !r,rirnll;til;,i ss ...,....,, ;1> ,r. ., ,.;,:, ,,.,t,a . ;; nn t 1=,*:..,::,:!,!arsel., ri r
<br /> i ,l;l�€={fJ6((11`.;ff(( ,.r.11,i,i,IE ] ,1,f� g. ,,,.i..,.c.:� I F i i � ,, i i , �; 1 I t ,t i I,,� -��,,,I=:,�f 11I t, F'-I,t:l;:i:lilllrfl`i't t,r, t:t�asEl,tl1 i1°`I�`J�i
<br /> Iffy{,{, s..f i.ifll i, d lllllilii' "i 1 if1'E 111 1 : ..�#.�1L4,Yg 0111�� M I`tf'.E'lif ;f�i�ill3Eil i ,1p II III , =1l, I'
<br /> ,s�=S�If�P11fi,.... (€ILII �I,,... 1a1111, 1,� t �t,lll,�E m;lhlr,iu�,,,�dr,..�. �,��,'� r � ��I' �,� � �� �,�'�i� � l!� �,,�L�I,�,�i,iaTa���iiil fl Il II di�ir �i, X11 E,1.
<br /> i ., r,rt , � f- ,., ,,i orr n�Pa vi IldMwe.I u,t f74 , .,,:,,, ,-{,,I I,,.t3t.,,,..,,s(...1 ,, ,.....
<br /> CONTRACT PRICE OF WORK: $ , pep c2P°
<br /> NUMBER OF DEVICES (if low voltage); 1 iNy-
<br /> FIRE ALARM? d YES ] 10
<br /> ASSOCIATED BUILDING PERMIT#Sif applicable): 16 t We 1J ( Y. pc e C A ' CJ,C-N
<br /> DESCRIPTION OF WORK: ,) 1 A * �rc_(\-tAr�' 1W>e.y�t it) 0()CU Qac pe c
<br /> ..IZ3, S Co-1 c. e.. ,.Q__y,i.s' % , ' ..._\.I C fJ.c,ia u1. R- J
<br /> ,,r;';:�,,r s:s:.y..,ugr i.i1i r.i��i�s::{�. : .���....,,.: J.lE;d r.,,.�,a:........ .......... ,,.::,�1.1 � � .. ,r t 1 fl ,::,a�:,��.r.., �. :. u;:t'i;;.,.,.,: ....... I:aiEr�rr�,,.,�. ..1.��ty'G'I's i�r
<br /> ii i ,,fI a.,...L.1.fai Plu,!, ,: 1 ,c i .it n,4 I I Y li Jk,,i 11 ,ilE, gj y� y.Vy� q. ii, i: E,,iil�,I :,t' 1 i �d. iIIE 1111�11111`;fkl�ll,iI 1 it N
<br /> (lf,t, 1.,11,,if!,giri Ipd!'�I! a f, .,, ) ',!I i71I1.c i; .`;r 1.,,: �r :.i,i•: i ,;' ; .I u i i if , I I iI I!d 7
<br /> ,
<br /> •
<br /> y,,..,,t lallfd}: i J:. t„i.,-.,.`11�lafJii h:� ,(d„ ��11l1,„l1,„ ,.. ���::�'.�I;;,,,�� 1� I� , ,� ,;1, , „�,�.i�l � ��`i�' ,�u1.�.1, i L 1 o h •('
<br /> OWNER NAME: Ma. C,t,� MO IFENANT NAME If Commercial : • (. A . t AL
<br /> OWNER MAILING ADDRESS: sTR. y
<br /> ,v YV,c..LX Ar-4\,k_ STATE 1/4....,8._.aS AP 9V51,9
<br /> OWNER PHONE: OWNER EMAIL;
<br /> CONTRACTOR NAME; \\o\iNc . \A.XI ?.e`(-)"C...., LL.C.....
<br /> CONTRACTOR ADDRESS: STREEVO 1-60}t, Q n
<br /> 11-Y`-ba11he,1\ STATE �1�-'t ZIP Cg )4.k
<br /> CONTRACTOR PHONE; 4)-S~i c\-o i ct \ !CONTRACTOR EMAIL: /I1
<br /> CONTRACTOR LIC.#REQUIRED: %O'(`(1 ' -, ..#--1 V CITY OF EVERETT BUSINESS LIC.#REQUIRED : 1V
<br /> _ ......... .. r^.,.......am.,mrm.mrwnn
<br /> PRIMARY CONTACT: 0 OWNER .Va1I ONTRACTOR 12 OTHER(Please Specify)
<br /> CONTACT NAME: !� CONTACT PHONE: ,��,t-ll/CI...,C71e-� 1
<br /> t .alt A �,1 l r\- CONTACT EMAIL: g.,,►.,. .yeasa-i 1) l •
<br /> 1 .:�, . ...1r. G .... 9
<br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same be true and co ect. .11 provisions of laws and ordinances governing this
<br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give au- to violate,or cancel The provisions of any other state or
<br /> local law regulating construction or the performance of construction, That I am authorized by the owner of this property to perform the work for which application is made and I
<br /> comply with the Stale Contractors Law 18.27 ROW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> 4 e 73dO
<br /> PERMIT#
<br /> -, ---N.--6— -
<br /> .--6 51 U2 f icoJED -0?Pi
<br /> • . Autho zed Agent Signature Date (Revised 10/12/2015)
<br />
|