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Jul 281712:36p Ferrin Electric IT] I 3377746 p.2 <br /> 1 <br /> I <br /> I <br /> ELECTRICAL PERMIT APPLICATION! <br /> '► CITY OF EVERETT PERMIT SERVICES l <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps©everettwa.gov I www.everettwa,govlperrnits <br /> PROJECT ADDRESS: ) '3 1 o SF � <br /> ( 1. <br /> l <br /> los <br /> { addition) ` 's 1j S F <br /> BUILDING AREA if residential, new construction, remodel,or I <br /> BUILDING TYPE: D SFR-DETACHED SFR-ATTACHED O DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 1 6.:\.r 11il1' �. i <br /> :. ...: ..,.. . . ..:...,.. ...:•:... :.:..-,.:.... L CTRICAL:A..IsPL CATMON,INCO. IMAT ON:;::V', ::;�` ;"::':' . :... .. <br /> 1')(, U t a <br /> CONTRACT PRICE OF WORK:$ / i c(, , I <br /> NUMBER OF DEVICES (if low voltage): _ f <br /> FIRE ALARM? D YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: IA \' )a,'% I fv i jr <br /> -V!'v f <br /> i <br /> li <br /> i11 <br /> 3 <br /> 4 <br /> •� ..::CO*TACT.:- NFORM04:ION <br /> OWNER NAME: k� s>'&VICE-Wj j [NI-�,i -c-;\L1,.LTENANT NAME(If Commercial): , <br /> OWNER MAILING ADDRESS: STREET rat L 5\4 r V\4k! ‘INJ l'i1r <br /> CITY EYvWt �STATE� A zip 01 ),(11-1 I <br /> OWNER PHONE: t-1 S l'‘63 ;-asT OWNER EMAIL: I <br /> CONTRACTOR NAME: cc-NA CV(,Av'i•1 <br /> CONTRACTOR ADDRESS: STREET TO `, ,L�; j <br /> �/� / ly y4 Jiff "� PAI <br /> GIT.( �P \1 ''"`R,Y� STATE V, �' ZIP riq Y% J Ii. <br /> CONTRACTOR PHONE: ),.) 3•�Jj 53-465 CONTRACTOR EMAIL: $-'C cLiP;V'i etcO'(l(,Mx a (INV) r <br /> CONTRACTOR LEC.AREQUIRED): k—e....lir• .. c`\3 C7 W c CITY OF EVERETT BUSINESS LIC.CREQUIRED):Q530 L). <br /> PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4-)6 S Oe4 0'e\1 . <br /> e <br /> MG\A c.-C';Y \ CONTACT EMAIL: 9\t:4n 6i} kui Atte i.-,k-illl 'i( tLirw <br /> AGREEMENT I hereby certify that l have read and examined this application end know the same to be true end correct. All provisions of laws end 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 stale or F, <br /> local law regulating construction or the performance of construction. That lam authorized by the owner of this property to perform the work for which application is made and 1 B <br /> cornp:'y with the Stale Contractors Law 18.27 RCWand 296.200 WAC <br /> i <br /> r <br /> City of Everett Official Use Only <br /> I `3 1-7 <br /> PERMT# i <br /> i Yy 1 <br /> I.:\ <br /> .–) <br /> i <br /> t 0- <br /> _,--___ <br /> E 1—1 off—21 e <br /> OwnerlAuthorized lt•ntSignature Date (Revised 9/23/2016) <br /> l\ r <br /> 1 <br /> F <br />