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Jul 17 17 09:08a Ferrin Electric Irip3377746 p.7 <br /> III 1 <br /> i <br /> I <br /> 14677 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©everettwa.gov I vwvw.everetiwa.govlpermits <br /> ::::.:,... . .. TE:1 . FO1*AT ON'; : _ :< ;.':- ,°:Q:•.::..`. •:....... ::.s ;>;!!:;;,. ::' ?<•:.::. ; ; <br /> PROJECT ADDRESS:1 ci U -A,0,11‘ i ,S- ,A 1u 3 ` <br /> BUILDING AREA(if residential, new construction,remodel,or addition) +J�+ +� SF 1 <br /> BUILDING TYPE: 0 SFR-DETACHED jig.SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: [A\..iy',,,NI,S <br /> ....... .. <br /> . ..... .:. . .. .. - .... . <br /> . ..... ....... ....: EI. CTRICAL:APPLlCAT ON 4NiFORMAT QN'';:;`'..'-'' ::'';' . :.. <br /> CONTRACT PRICE OF WORK:S 1 j p 0 ,i)R <br /> NUMBER OF DEVICES(if low voltage): <br /> I <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: \elk ALN.21 c0V\ r'Iti J\( <br /> i <br /> t <br /> t. <br /> I <br /> y [ ..:..: .:-,:: 1::.:'.::-0.0j74:0741400.#01.4100.:0.':::':`::..: ; <br /> OWNER NAME: �1 c, 1K1. - J-{, h L.:i.,I,TENANT NANIE(If Commercial): <br /> OWNER MAILING ADDRESS: sinter I ?I,O lj\AJ v� V e �► IAt/.� , (� ()LI , k <br /> cry E STAIEAv A zsp Ci `J)\tr"T <br /> OWNER PHONE: TS el r A ott OWNER EMAIL: <br /> CONTRACTOR NAME: :rti t NI\ el/LA. 1 <br /> 10 WA 1�.1 a <br /> CONTRACTOR ADDRESS: sTneErr <br /> CITY . '`j\ (. STATE V til GA ZIP c AI <br /> CONTRACTOR PHONE:Li-as �'�`-) 6 3;5 CONTRACTOR EMAIL t;,Ui �>, '�(.f uiV e V.(ill(..fin(t corp <br /> CONTRACTOR LIC.#(REQUIRED): C�3 4 kr' r <br /> �IL��'�t�I � i� CITY OPEVERETT BUSINESS LIC.#(REQUIRED):053q <br /> �V <br /> PRIMARY CONTACT: *OWNER EI CONTRACTOR 0 OTHER(Please Specify) r <br /> It Ii <br /> CONTACT NAME: CONTACT PHONE: 'F'36 S Oil cCO L. <br /> CONTACT EMAIL: N/ ) <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type is <br /> of work will be completed whether specified herein or not. The granting of a parrot does not presume to give authority to violate or cancel the provisions of any other stale or N <br /> local law regulating construction or the performance of construction. Thal I am authorized by the owner of this property to perform the work for which application is made and l t <br /> comply with the State Contractors Law 16.27 FICW arm 296.200 WAC. fi <br /> li <br /> !r <br /> `, City of Everett Official Use Only <br /> 0-------- PERMIT# '± <br /> I 11 1 -3 i 1 -1 E 1j4 — Oto <br /> Owner/Authorized ••-nt Signature Data (Revised 9/23/2016) <br /> ; <br /> k <br />