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04/25/2017 21: 45 14257" 60 ACTIVE ENGINFPPING PAGE 02;'02
<br /> ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> OL 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 FAX 425-257-8857 i (E) everetteps@everettwa.gov j www.everettwa.gov/permits
<br /> ^ .r,a lFI ';''IBC J,(II'7 Ij r♦r �,M1�yV J hf.Gl r it l r I(`�:Y 7.'�'Ij,r I'{i}I� P' .. ',., ( .t,..,yyY, .,.. ,,�{py . , .�y.�., µ� .,M,fi �',+rnl(`y'y{!i Y 7�; �;ry f }' �( !il"ili`rl,`,.$)lsr'�N I f r�) 11I{ 3`r`�1!
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<br /> PROJECT ADDRESS: 6509 Broadway, Unit 2, Everett, WA. 98203
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: 13SFR-DETACHED LiSFR-ATTACHED 11DUPLEX IZJ MULTI-FAMILY-#OF UNITS.4 ❑ COMMERCIAL
<br /> uSE OF BUILDING. Housing
<br /> i;r,t�,,l l s h. ,114 , ,{;El,a ,�, ,,rl,l { ,,f,��'i '�'I�����1�P�►1��+t����+�rlu� rlt�r;r; �`�r����i�,I yti .��rxz�:,;(hI I ,,i�{ { �� ,�I +:fir r ;,1 ,I(„
<br /> CONTRACT PRICE OF WORK: $ 550
<br /> NUMBER OF DEVICES if low vc lta e : 1
<br /> FIRE ALARM? ❑YES ® NO
<br /> ASSOCIATED BUILDING PI✓RMIT# if applicable);
<br /> DESCRIPTION OF WORK:
<br /> Change out existing 125amp panel.
<br /> AT �W yy
<br /> s
<br /> OWNER NAME:Washington Home Of Your Own TENANT NAME If Commercial),
<br /> OWNER MAILING ADDRESS: STREET
<br /> cm STATE ZIP
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME. Active Engineering/Neighborhood Electric
<br /> CONTRACTOR ADDRESS: sTRasr 6605 200th St SW
<br /> CITY Lynnwood sTATB WA zip 98036
<br /> CONTRACTOR PHONE: 425-776-8119 CONTRACTOR EMAIL: admindesk@aotiveengineering.net
<br /> CONTRACTOR LIC.#(REQUIRED): ACTIVE*OSSMS ICITY OF EVERETT SUSINESS LIC.#(REQUIRED): 026245
<br /> PRIMARY CONTACT: ❑ OWNER ©CONTRACTOR LZl OTHER(Please Specify) MaintenatlCs'� Lpervisor
<br /> CONTACT NAME: CONTACT PHONE: 425-345-6174
<br /> Josh Ruuth CONTACT EMAIL:
<br /> AGREEMENT.'/hereby certify that 1 have read and examtned this application and know the same to tw true and correct. Alt provisions or laws and ordinances S1overning this type
<br /> of work will be completed whether specirrod here)n or not, The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or
<br /> local few regulating conervobbri or the performance of construction. That I am authorized by the owner or this property to perform the work for which application is made and t
<br /> comply with the State Contractors Law 16,27 RCW and 296.200 WAC.
<br /> City of Evsrsft Official Use Onty
<br /> PERMIT#
<br /> `Ll 4/26/17 E I�l 0 - 1
<br /> owner/Authorized Agont Signature 02te (Revised 9/2 312 0 1 6)
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