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Jul 281712:36p Ferrin Electric Iran inr3377746 p.4 <br /> III , <br /> I <br /> OLT 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 (E) everetteps©everettwa.gov 1 www.everettwagov/permits i <br /> E. T <br /> ( I <br /> PROJECT ADDRESS:_, Till !. , <br /> 9 QG ' , S& E c*b ., <br /> BUILDING AREA(if residential, new construction,remodel,or addition) r,Cl) SF <br /> BUILD€NG TYPE: D SFR-DETACHED X SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: —V(;`.)d' 6.41` <br /> :.::....:.: . <br /> ........ <br /> ........ . . <br /> ... . .... . ....:..:......: ..:. .. .. . ., . �..... ..' . PL .CAT. <br /> CONTRACT PRICE OF WORK: $ -1's' ') ,i't <br /> NUMBER OF DEVICES{if low voltage): <br /> I <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT* if a plicable: <br /> DESCRIPTION OF WORK: (L( /e ,•,,..s i -) \ (iy \[ f <br /> C <br /> t <br /> .: <br /> v: i.. <br /> li <br /> OWNER NAME: Nix 47;1 Iik.1 Dci?_e.A itdivN\L1 TENANT NAME(If Commercial): <br /> ` <br /> OWNER MAILING ADDRESS: STREET i ).L \A) v 0.01 <br /> ,/�v 1' . V' )i <br /> . 1 <br /> CITY L...4 4`Y STATE"vl A ZIP CI glii <br /> ij <br /> OWNER PHONE: ti).S 41 -3 , OD OWNER EMAIL: ll <br /> CONTRACTOR NAME: �-(,-{.11.Y`g .L-7\-- (. <br /> a .,- , <br /> CONTRACTOR ADDRESS: STREET <br /> {�,/ t ��; �/i{t v <br /> CnY 1I %I / C"-Lt. STATE Vg t'� 21Pel%Pca I <br /> CONTRACTOR PHONE:4d,5 3.S I 5a ,' CONTRACTOR EMAIL: 2 d ; ccf�;l,\(l. f iC-'1\r1( ` ,�' il� <br /> w ii <br /> CONTRACTOR LIC.#(REQUIRED}: f(?,('{',Ci 013,9 J f CITY OF EVERETT BUSINESS LIC.#(REQUIRED):0539(.)'7 `l <br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: r�� CONTACT PHONE: 11-36 �S C al:11+L / r <br /> ii <br /> MY\ z'i`\ } CONTACT EMAIL: G�IAA ht,. C-fi ti;i4tdLL��14,iy( .� tvv <br /> AGREEMENT:I hereby cerll,y that I have read and examined this application and know the same to be true end 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 /> focal taw 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 1 <br /> comply with the State Contractors Lew 18.27 RCWand 296.200 WAC. <br /> i <br /> Li <br /> pi <br /> P <br /> F <br /> F <br /> r.\\1/4,.... City of EverettOflroia,Use Only f <br /> / fl-----_ -7) a ( ) i 1 PERMIT 7F '� <br /> Owner/Authorized to Signature Datel <br /> (Revised 9/23/2016) <br /> t <br /> 1 <br />