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Jul 17 17 09:06a Ferrin Electric Ir? 11 3377746 p,4 14r". ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwa.gov I wvtw.everettwa.govlpermits PROJECT ADDRESS: —1 Gl aQ --3,(;A-}A r1\1 . 5 k. 1.4.1-1- BUILDING AREA(if residential, new construction,remodel,or addition) t F+ SF BUILDING TYPE: ❑SFR-DETACHED iNSFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL I USE OF BUILDING: —r(..,:}.g, ,rte ,J i 5, EC. <.:.. ....:. , .. ... ...:..... . .'�' . C.4 . P.PLlCA 1aN;':INF RMAT ON":.'N; i•:� i ':`>,:..... CONTRACT PRICE OF WORK: $ 1,o i 1 NUMBER OF DEVICES(if low voltage): I FIRE ALARM? 0 YES 0 NO I 4 ASSOCIATED BUILDING PERMIT it qf applicable): DESCRIPTION OF WORK: VV t\( , v...)i-\ 9`w.k( i I f, .... ... .:.: . :>is `A� I OWNER NAME: NI 1 ►i. ick;5i' db,)_ti LILTENANT NAME(If Commercial): -I 1 OWNER MAILING ADDRESS: srRsar .;),0 S vj f;1'04rd V tkii Wei(jy J 9400-1 ; CnY '�+�'i'�F 1� STATE A ii OWNER PHONE: 1 ' S 41 J a LID OWNER EMAIL: x CONTRACTOR NAME: "c'ii A et L�;;'i( ti CONTRACTOR ADDRESS: sTREeT VO , 9)0)( 1MA h COY V '\11' civt.tX , STATEIN 21P Cfc MI ` CONTRACTOR PHONE: ),5 3;31 S 3.ct 5 CONTRACTOR EMAIL 7+1 rr ct 1.611‘v N,tt alfi C:1\11( c CON\ CONTRACTOR LIC,#(REQUIRED): .l',rr.y Eji 3 9 IVC CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 3O -) PRIMARY CONTACT: OWNER ❑CONTRACTOR 0 OTHER(Please Specify) - CONTACT NAME: CONTACT PHONE: t SOS cf. `. i\\0 D .7 in CONTACT ENTAIL: A1g\n 44'A t.tt iii IC.,�t , �e 4.,i �' t if AGREEMENT I hereby certify that 1 have read and examined this application and know the same to be true and correct AU provisions oflaws and ordinances governing this type ,i of work will be completed whether specified hereto or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the ownerof this property to pertain the work for which application is made end I comply with the State Contractors Law 18.27 RCWand 294.200 WAG. a u 4<. s F r, City of Everett Official Use Only :I '� f ""7 11 PERMIT# ) )`+� c)------ - E - to 1. Owner/Authorized 't ent Signature Date (Revised 9/2312016)