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08/09/201? 10: 00 14257751960 ACTIVE ENGINEERING PAGE 02�`02
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<br /> ELECTRICAL PERMIT ,ApPLICATION
<br /> CITY OF EVERETT PERMIT SERVECES
<br /> 32Q0 CEDAR STREET, EVERETT, WA 98201
<br /> (P} 425-257-8810 J �AX 426-257-8857 � (E) everett2ps@everettvva.gov � www_everettwa.gov/permits
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<br /> RROJ�CT ADDRESS: ZO�� H��/� AVe "� 'ni ' I ti':.: ' , I , .I:;;' ,,b��(.,��k�
<br /> �IUILDING AR�A(if residentlal, new construction, remodel, or addition) SF
<br /> SUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#�OF UNITS:4 ❑COMMERCIAL
<br /> USE OF BUILDiNG; R@SlfjeflC�
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<br /> �,r,�.: f�����i,!;o , , ,� 'I+ �( KM i ■r= )1 1 �Y,48 v h 1� 1
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<br /> CONTRACT PRICE OF WORK:$ 3200
<br /> NUMBER OF DEVICES if low volta e :
<br /> FIi�E ALARM? �YES �NO
<br /> ASSOCtATED BUILDINC pERMITl� if a licabfe :
<br /> ��S�R�PT�oN OF wor�K: Replace (2) existing panefs on outside of 4-plex
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<br /> OwNER NAME; James RetyCh 7ENANT NAME If Commercia.l :
<br /> oWNER MAlLING Ao�ResS: sT�EEr 20�� HOyt Ave
<br /> arr Evere#� 57ATE �NA z�a 96201
<br /> pWNER PHONE: �06-799-8009 OWN�R�MAIL:
<br /> coNSRqc�roR Na,ME: Active Engineering/Neighborhoad Electric
<br /> CON7Fz4cTOR,a�pR�SS: s„���6605 200th St SW
<br /> cm Lynnwood sTAT� WA
<br /> Z,p 98036
<br /> C�NTRACTOR PHDNE: 425-776-81�9 CONTRACTOR EMAII�: �d�711fiCIf:S}C Q�aCtIVeQllgjflE?@�jflg.fl@t
<br /> CQNTRACTQR LIC. REQUIRED): ACTIVE�Q$$MS CI�'Y OF�l/ERETT BUSINESS LIC.#{REQUIR�D: 0262�8
<br /> PRIMARY CONTACT; ❑ pWN�R m CONTRACTOF2 ❑oTHER(Please SpeCify)
<br /> CONTACT NAME; CONTACT PWONE: 425-776-81 1 J
<br /> Bii! Harris cpNTAcr Ennni�.admindesk@actiweengine�ering.net
<br /> AGREEM�NT:1 henrby caMiTy thet!have�d ar�d examiner!(his epp/lcallon end krrow tHe same fo he fn�e 8�corrmcf. Al!provisfons or 1Avrs a�r0 orelnanczvs goveming this type
<br /> ofWork wi11 be�omplef6d WAetHerSpecifiedherelrt ornaf. TA9 granting ofa permKdpss not pY25ume to give au(ho�lly t0 violate or cancelthe prav(Slpn�o(arty otHer stafe or
<br /> local law regufeNng conslnaclJon or fAa perPormer�ce of consbuctiort. That 1 am autho�tzed by 1he ownar oi thrs pmper�y�p��/a�tha work for whlch appNcetivn Is maas antl l
<br /> Camply WitH fhe Sfate Canf�g�p�Lew 13.27 RCW end 296,200 WAC.
<br /> , C!ry of Everett ot�icra!Use Only
<br /> ' P�RM1T#
<br /> � � �� � � E l�lD � �b��
<br /> oxmer�Autborizad Agent Signature Date (Revised 9i23P20iB)
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