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Jul 1717 09:08a Ferrin Electric Irt 4? 3377746 p.6 <br /> 1 <br /> 4rerr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps©everettwagov j wo,w.everettwa.govlpermits • <br /> .,.. CT.SITE;-INF R AT[ON•:>: ";:�:::::_ ':`:.I:'., • .;'..�:;:::;':::'::.:: <br /> PROJECT ADDRESS: 1 Cl 14 Ac 1 1 T E 5� 1._c t <br /> i <br /> BUILDING AREA(if residential,new construction,remodel,or addition) as t la SF j <br /> BUILDING TYPE: 0 SFR-DETACHED ,§SFR-ATTACH-IED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL f <br /> USE OF BUILDING: --rC: y',\Nir'"A(. , <br /> I,...7- .. ..:. - .... ,.. :.:: .... .....EI. C :RICAL:#1•.PIL[.CATIdPI1NiFOttMATION:° <br /> CONTRACT PRICE OF WORK: $ 1 t (,ti 0 a <br /> NUMBER OF DEVICES(if low voltage): <br /> J <br /> FIRE ALARM? ❑YES 0 NO i <br /> ASSOCIATED BUILDING PERMIT it(if applicable): I <br /> DESCRIPTION OF WORK: \ill 1;(\k 1 ,N. i eN)r hOfk,( i <br /> i <br /> 1 <br /> i <br /> OWNER NAME: P\11 i 1 \k EMS 4,t n\La_TENANT <br /> gNAME <br /> 1(If Commercial); i <br /> OWNER MAILING ADDRESS: err sar 7J 'd'�,L �) f I 1 f'`ki v��1 t<n , <br /> OFrY E64-;:rt--A STATE v V A .p9Ot if <br /> OWNER PHONE; IliO OWNER EMAIL: <br /> 'CONTRACTOR NAME: c(, `Y'\ et.€,,, ,6 <br /> fi <br /> CONTRACTOR ADDRESS: srREET 1 O , )) I�,I,t <br /> cr, 1 ".,,\, t. STATE VIA ZIP qeice i.` <br /> CONTRACTOR PHONE:4 6 •3.3 I 3(i S CONTRACTOR EMAIL71:42,,f VL( C f-NA C ,,t k L 1 CV\ry k <br /> CONTRACTOR LIC.#(REQUIRED): �_('C r�t Ci 7j°9 .1\}c CITY OF�EVERETT BUSINESS LIC.#(REQUJRED):O53C'�( J <br /> PRIMARY CONTACT: XOWNER Cl CONTRACTOR 0 OTHER(Please Specify) , i <br /> CONTACT NAME: CONTACT PHONE: 1^ 36 j o' a 6\1 L <br /> : ,r <br /> f (t��NAME:. <br /> CONTACT EMAIL: A14110 II 11,4 c tt,L- d)Lie' {-,L(.hAy'1 <br /> • <br /> AGREEMENT I hereby certify that i have read end examined Ibis application and know the same to be true and correct All provisions of laws and ordinances governing this type �; <br /> of work will be completed whether specified herein 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 law regulating constriction 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 I, <br /> comply with the State Contractors Lew 18.27 RCW and 296.200 WAC. <br /> ii <br /> It <br /> I11; <br /> S <br /> \ City of Everett Official Use Only <br /> 1 ^� PERMIT# li <br /> ) 1 7 4 <br /> `r —�-- E ,1% - l05 F <br /> Owner/Authorized4 s-nt Signature Date (Revised 8/23/2016) <br /> i <br /> e <br /> N' <br /> 4' <br />