2525 W CASINO RD BASE FILE 2022-04-07

01/18/2019 11:47 14257751960 ACTIVE ENGINEERING PAGE 01/01 tLtt, (RICA[FRMIT & FIRE ALARMRMIT APPLICATION etj CITY OF EVERE T PERMIT SERVICES A►/' 3200 CEDAR SIRE T, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-2578357 I(E)everettepsceverettwa.gov I www,everettwa,gov/permits • PROJECT SITE iNFORMATION 5' PROJECT ADDRESS❑: Z 5 W t+a ('qtc in 6 R. I A_ Ewe/x.44— ci kzo , PROJECT TYPE; NEW CONSTRUCTION ADDITION Nr TENANT IMP'ROVMENT u REMODF_L BUILDING USE; ❑SFR fl TOWNHOUSE C]DUPLEX ❑ADu ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL BUILDING AREA. /Zo sq ft ______- ,4662LICATION INFORMATION CONTRACT PRICE OF W•; •CIATEO BUILDING PERMIT#(if applicable).1A (�� IS THIS LOW VOLTAGE !� _ DEVICES; �i IS THiS A FiRE ALARM PERMIT? �: NO 0 YES-Plans required for iew(Both Electrical and Flre Department inspections are",qulr� DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: //15 II d-cdICG -- d 0-o v1, f rC uta IT. too l IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: gBelow By checking this box, I am stating that I have read and Understand all of WAC 298 46a-90Q sellecteDeE specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ►' 0 EYES-Sefl Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent, sale,ori ase w hou I I the proper electrical licensing and certification,or exemption, By checking thls box, I am stating that I have completed and signed the see Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: /YYO s/ e_______1cc."fy-OnIG 5 TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS; sTFtt Er E P •hDrGrviG Cdr"c � CRY r>iyJ C41 n i ci l. (' 0 112 OWNER PHONE: '3+53 4,60 . j _ VATS4 7,1p ,Y1 [OWNER EMAIL: Sh . /AA cyto vv, CO", CONTRACTOR NAME; Act let C r- G' � 4 CONTRACTOR ADDRESS: sTReeT , 6 65 Z Ob-h, d+ S�" J cavi y1 i't fA/OO rely CONTRACTOR PHONE: ' 15- STATE ZIP cla v3 6 77.-Y1I' CONTRACTOR EMAIL: (o bei—II P 4C-live eKc i el Ce,-l-, - r G 4- CONTRACTOR LIC.#(REQUIRED); -{-itI -4(I rrn5, CITY OF EVERETT BUSINESS LIC.#REQUIRED; 26 l4 -,• PRIMARY CONTACT: Li OWNER 'CONTRACTOR L..i OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z6l 3 (.)r d01fc hG SGtA.dti l CONTACT EMAiL: ! AG1 EMENT:I hereby certify that I have read end examined this application end know the same to be true end correct. All provisions of laws and ordinances governing this type of work will he 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 local law regulating construction or the performance of constructinn, That lam authorized by the owner of this property to perform the work for which application is made and i complywith the State Contractors Law 18.27 RCW and 298.200!NAC. / 2-5- 776 - g,!/q yii. , /0Gy44 \ City of Everett Official Use Only a(4 ' PERMIT# 'belie) (4'10 ( - S3 I OwrtgrlAuthorized Agent Signature � Dale (Revised 11/5/2018) Page 1-Application