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Aug 30 1711:39a Ferrin Electric In 111377746 p•4
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<br /> ELECTRICAL PERMIT APPLICATION
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<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-267-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.govlperrnits
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<br /> PROJECT ADDRESS:
<br /> BUILDING AREA(if residential, new construction,remodel,or addition) +�[a0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL{r e d 0
<br /> BUILDING TYPE: ©SFR-DETACHED SFR-ATTACHED 0 DUPLEX \
<br /> USE OF BUILDING: (ti N _
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<br /> CONTRACT PRICE OF WORK: $ i Cj WO , 1
<br /> 'NUMBER OF DEVICES(11 low voltage):
<br /> FIRE ALARM? EI YES C NO
<br /> ASSOCIATED BUILDING PERMIT#(If applicable):
<br /> DESCRIPTION OF WORK: W ,y- "y prJf\ \1 jy
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<br /> OWNER NAME: i 6)NQ, WI-\1S -,1•el' t. LI.LTENANT NAME If Commercial
<br /> OWNER MAILING ADDRESS: STREET ra.0 Evm,fit V\40 t{
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<br /> OWNER PHONE: (• .S 4/1 63 • els OD OWNER EMAIL:
<br /> CONTRACTOR NAME: c-tfd-A, `LVILAf••ti(
<br /> CONTRACTOR ADDRESS: STREET TO ?)O)( 1;, `6b 3
<br /> CITY PA l r (.0 t. STATE V r' i ZIP' U k
<br /> CONTRACTOR PHONE: . )5 �3 5...)3<5 CONTRACTOR EMAILvn
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<br /> CONTRACTOR LIC.#REQUIRED): ce,_c.;ci G 3 1v CITY OP EVERETT BUSINESS LIC.#(REQUIRED):05361D�
<br /> PRIMARY CONTACT: XOWNER ©CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 1-1-3,6S OS O X11 L
<br /> 1y -4,-1\t1n CONTACT EMAIL: A;C (ice} `r
<br /> AGREEMENT 1 hereby c2erflfy that 1 have read and examined this application and know Me same to be lam end correct All provisions of laws and ordinances governing this type 1
<br /> of work will be completed wh etherspecified 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 /> local law mutating construction or the performance of construction. That 1 am authorized by the owner of this property to pedant)the !s made and J
<br /> the work for which e s
<br /> comply with the State Contractors Law 18,27 ROW and 296,200 WAC. t
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<br /> t City of Everett Official Use Only
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<br /> PERMIT# }
<br /> �r1/11I? 1 ) --) 40g - 2- 1 -- r
<br /> OwnerlAuthorizod • ••:at Signature Dale (Revised 9/23/2016) e
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