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Jul28 1712:37p Ferrin Electric If] 13377746 p>6 <br /> i <br /> 1 <br /> Or147 .7 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 1 (E)everetteps@everettwa,gov 1 vdww.everettwa>gov/permits 1 <br /> i <br /> ._. _...... : PROJE Ts:S0TE::1 FOEi ATI.O <br /> PROJECT ADDRESS: 4 t:1G) 0 5 \ 61' S E Lu ti� • <br /> %(51I <br /> . <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF ' <br /> BUILDING TYPE: 0 SFR-DETACHED SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: �( �,.a4�11,s�r+1.Q, --- tt <br /> E <br /> ; <br /> SECT . <br /> .... ......._. .l,_ ...�... . .........:..... .. . .. R , A ..LIC tit AT <br /> � P AT �1 F <br /> CONTRACT PRICE OF WORK;$ 1 ffi <br /> NUMBER OF DEVICES(if low voltage): <br /> i <br /> FIRE ALARM? ❑YES ❑ NO i <br /> E <br /> ASSOCIATED BUILDING PERMIT#(if a licable: I" <br /> DESCRIPTION OF WORK: 'A) t fik. a,-\,..1 )1 v\-)N }'\iivA . i <br /> E <br /> . i <br /> 7 <br /> i <br /> si` <br /> F <br /> I <br /> OWNER NAME: 1 If> <br /> \k .%ssic bra-e.kt;�Li(_TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1 t,,t 'S € � I'M V in <br /> cR'Y v vrV y STATE‘AI ZIP Ci 11 4"7 <br /> OWNER PHONE: I" S 67%G3 c LD OWNER EMAIL: <br /> CONTRACTOR NAME: V"{,f)t CV(�yl-A-y�•1 <br /> CONTRACTOR ADDRESS: STREET TO ., 5'1)0 C.-1%4'11K .,l , r ` <br /> CITY \;1C.-1%4'11K STATE \) A•A UP ) J 041 <br /> y�, '� l II <br /> CONTRACTOR PHONE:� •p3,� <br /> �J 1 �� 5 CONTRACTOR EMAIL�l�L2'ti� l{�{��� ��• 6':t CM c.�.O� 4 <br /> CONTRACTOR LIC.#(REQUIRED): kin-y f...i cl3 9 WC CITY OF EVERETT BUSINESS LIC.#(REQUIRED):Q3Gr�1) J <br /> t <br /> I <br /> PRIMARY CONTACT: XOVVNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1'�- S . 0.1:- ') <br /> �l�OW, '1 CONTACT EMAIL: A rl. r dQ. ti <br /> AGREEMENT:1 hereby certify that 1 have read end examined this epplicalro,and know the same to be true and correct All provisions of laws and ordinances governing this type <br /> of wont will be completed whetherspecitied herein or not The granting of a permit does not presume to give authority to violate or cancer the provisions of any other state or •F. <br /> local law regulating construction 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 <br /> comply with the Stale Contractors Law 18.27 RCW and 296.200 WAG, <br /> li <br /> i <br /> I! <br /> i . 0_____ ' la.cg I 1 7 ..._— <br /> City of Everett Official Use Only <br /> —} PERMIT# <br /> Enol- ILD <br /> Il , <br /> Owner/Authorized •.-ntSignature pate (Revised 9/23/2016) <br /> 14•a <br /> r• <br />