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Jul 171709:06a Ferrin Electric Ince 477746 p:2 <br /> I 1 <br /> 4rErr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ..':. :.:':::::.-1,:: ::, . . <br /> :.....:_ :: . .. ...... .. . . : :... :. .. .. .... . T;z <br /> �R01 CS TE;�' NFORNfATN`= :. <br /> � ; :'=:.�: :;,::.:. : <: ; :: . :: •_:=..: <br /> PROJECT ADDRESS: 0\-- <br /> awls,T1 P . .c-F <br /> `�5 ice{; sF <br /> BUILDING AREA(if residential,new construction,remodel,or addition) <br /> BUILDING TYPE: DSFR-DETACHED XSFR-ATTACHED ❑ DUPLEX OMULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: -1-'0+ (N <br /> AL <br /> AIPPLICATICINASON:,(<; ;'::' <br /> i:;:;. :.:�::.... :. <br /> .: :..... ..: :.::.:.:: ::;.::..,; <br /> ` <br /> CONTRACT PRICE OF WORK: $ I V '� <br /> j <br /> NUMBER OF DEVICES (if low voltage): Y <br /> FIRE ALARM? D YES D NO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: kr" „..7_-� . - Pea.. <br /> , <br /> .....:.... ... <br /> CONTACT ' <br /> OWNER NAME: I,Ip,'l 1-1 yiS bC4-0(qatALL TENANT NAME(If zahCommercial); , <br /> OWNER MAILING ADDRESS: srer j j f r/\t, IA(Oil V jib{;� �k ' <br /> Gin, srare �/ A EP c1' <br /> OWNER PHONE: : 1:11'l as .t` .OWNER EMAIL: <br /> CONTRACTOR NAMM E: �'�.'{v �� �y�1�,•�,;�'1� <br /> CONTRACTOR ADDRESS: STREET VO 91O ) Utc. �J�t+p ` <br /> cn 1 ` t<i' ei At STATE. V' 0\ zip F 7, 0 A�. <br /> 2 <br /> CONTRACTOR PHONE: )LS _3 3 7 �j- i 3 CONTRACTOR EMAIL: �1;�tri,- rv, <br /> 1� ,e. a,„Liv ( £,.„iyryy <br /> CONTRACTOR LIC.#(REQUIRED): .�,('('y�.►C/3 c W c CITY OFiEVERETT BUSINESS LIC.#(REQUIf2F_D):063C`I O"1 <br /> _ <br /> PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> 'CONTACT NAME:, CONTACT PHONE: I4. 5 S 04 a 1 L <br /> 14 <br /> , `t\Y\ i vY\ ,CONTACT EMAIL: 05,�s+�et ea) 41 {,e 4,11 -►1'1(A tri <br /> AGREEMENT:i hereby certify that I have read end examined this 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 cr cancel the pmvisions of any other state or 's <br /> local law regulating constriction or the performance ofconstruction. That I am authorized by the owner of this property to perform the wort;for which application is made and I <br /> comply with the State Contractors Lew 18.27 RCW and 296.200 WAC. <br /> is <br /> ;i <br /> i <br /> ';'\ ___,,, <br /> City of Everett Official Use Only <br /> PERMIT# • <br /> Nii • 0.—.......... 1) 1 - .)) ) --) E 2_01 ,t, O 1, , <br /> D+vnerfAuthorized eat Signature Date (Revised 9/232011) <br /> S' <br /> i <br />