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Nov 22 1710:OOa Ferrin Electric lim FF3377746 p.4 <br /> '4rEIT' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 f FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa,gov/permits I <br /> ,Ytc <br /> 1� . .. .T..S1T.E.IN�O pT10N ... - `` - <br /> . �7 ... .. v_ -- .._............ ......:.... .SSI'-:i.... - .:... <br /> PROJECT ADDRESS: -1 CA 1 ' ��tt F' ` - .. <br /> r� <br /> BUILDING AREA(if residential, new construction,remodel,or addition) D kit SF <br /> BUILDING TYPE: 0 SFR-DETACHED SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL _ <br /> USE OF BUILDING: ---1- s�, 4�rr,,l;;.v <br /> S <br /> .... ... ..... <br /> CONTRACT PRICE OF WORK:$ .1 i L} V :........ . . ,.... .. ....-.... ,. <br /> VD <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? E YES ENO <br /> ASSOCIATED BUILDING PERMIT##(if a plicable : <br /> DESCRIPTION OF WORK: \'� {�l '- )1 ci.- \ \-0. <br /> I• <br /> ..:.:.:...:.. <br /> NT G: .:.; . <br /> . . ., NF <br /> , A. R AT O <br /> I <br /> OWNER NAME: NI ik.i c' p7Cq-e.}vikittA, 1 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srneE? �1'�.',,�L, y\� �1A,;,�� �d�il V'\!e.1....51 r� <br /> CITY EIMAi Ll STATa\ I�I�, ZIP 01 01.1. i. <br /> OWNER PHONE: I" )f) `,�G3 '.� 5D DOWNER.EMAIL: t <br /> CONTRACTOR NAME: c"t,-cq Tv ` , f.CA- - ' <br /> i <br /> CONTRACTOR ADDRESS: seel TO , +T)O)( I M I F <br /> } <br /> �tae jr <br /> cnY pi\ I C t��jt i, MP <br /> CONTRACTOR PHONE:'),5.; 3 ° 4 STATE i y <br /> CONTRACTOR EMAIL7r r�; ce MY') k 4 �I CM( I (:Elim <br /> ( ,._ c!J'( L1 c c ` <br /> CONTRACTOR LIC.#REQUIRED}; +� y3 1CITY O EVEi2ETT BUSINESS LIC.#(tiEQUIREi3): 3e1�� <br /> PRIMARY CONTACT: AOWNER 0 CONTRACTOR ©OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> f\\(AV\ C.44\1\\\,1) CONTACT EMAIL: ei r i . c _=rpt`J t yJ )( <br /> 1�1� ��I�V���YV L�l�• tl..i9,S1( t ii ?„.,1 <br /> AGREEMENT.i hereby certify that t have read and examined this application and know the same to be true and con-act AfI 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 /> kcal 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 f <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC. <br /> .t <br /> 3 <br /> r\\...._ <br /> t <br /> City of Everett Official:Use Only <br /> , ,. <br /> I1 <br /> PERMIT t# <br /> •-• 0---. r <br /> i a as <br /> JJi EI'1 \ II ; <br /> (1I[1 c/ 3 <br /> Owner/Authorized •••atSignature Date <br /> (Revised 9/23/2818) <br /> C• <br /> t <br />