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Nov 22 1710:02a Ferrin Electric Irm OFH3377746 p.5 <br /> 4L7 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©everettwagov I www.everettwa>gov/permits <br /> F <br /> PROJECT ADDRESS: 1 CI i t'\' I T_i bk 5£ !—L r L ` <br /> BUILDING AREA(if residential,new construction,remodel,or addition) DL�U• SF <br /> BUILDING TYPE: ❑SFR-DETACHED SFR-ATTACHED El DUPLEX O MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL _ <br /> USE OF BUILDING: —rq :IISINcy,r1 <br /> 4 <br /> E CTRlC ' `�' <br /> 14L A ...P, .: . ; <br /> : ............ ....... . . ,.. Q: ... . . . .I.ON NFaRM4;TON <br /> CONTRACT PRICE OF WORK:$ i.j CYO >lip, <br /> f <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? El YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: v) iskk.. Vit,,; 11 Ig•-)c VA ,V„r ?F <br /> a <br /> 1 <br /> z <br /> I <br /> . ., . :. ..: ... .... ........... .. .TAC ';IN)F`.ORMA <br /> ON <br /> OWNER NAME: (�j is is I <br /> � 1� ..\.m. •�C.�'Q.�I 'w�l�i.�T�EjN_ANT NAME(If Commercial): . _ ,. , i <br /> OWNER MAILING ADDRESS: STREET �1 a_,I ')' ) fjV v k� VJ�1a1 A'Jin, + A ``f I <br /> cry EN`'�'Y S'ATE"Vt TIP C "149- <br /> OWNER PHONE: I"k .j 61 63 ac..‘(OD06Vi <br /> NER EMAIL: li <br /> 'CONTRACTOR NAME: cl.-174'AV.L"4*vi i <br /> CONTRACTOR ADDRESS: STREET i 0 •, Jjo 1 ,c,c, r <br /> CffY `‘v C, ,ti STATE \I■ ti\ 2!P r I 1 r <br /> • 1 <br /> CONTRACTOR PHONE: 1,.j '' ,31 6"3<,t,5 CONTRACTOR EMAILTIOL y�,' cif r eN1 ei,� -I'1 ,sl^1( a(.p't , <br /> t. <br /> CONTRACTOR LIC.#(REQUIRED): C!-CC r€.,...1' 9:3[7�! I c CITY OP EVERETT BUSINESS LIC.##(REQUIRED):lj 3Cj 0 <br /> PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) '' <br /> li <br /> CONTACT NAME: CONTACT PHONE: -e6 L. h <br /> � SI p C` 1If <br /> O `1 1y) CONTACT EMAIL: A'f1S'1 �'fv • t 4 A et?.4.. -� d <br /> - �L_s'34 ,Lv'�1 V <br /> AGREEMENT.•I hereby certify that I have read and examined this application end know the same to be true and 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 10 give authority is violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That f am authorized by the owner of this properly to perform the work for which application is made and 1 <br /> comply vrith the State Contractor Lew 18.27 RCM/and 296.200 WAG. <br /> 1 <br /> I <br /> r:\,.. <br /> rF <br /> City of Everett 0.9icial Use Only <br /> PERMIT# <br /> l� I,1 _.• ci—_____ 11 I)a a) g ......, <br /> l (61Et <br /> 1 <br /> Owner/Authorized ntSIgirature Date <br /> (Revised 9/23/2096) <br /> u <br /> 1, <br />