7404 EVERGREEN WAY FIRST CHOICE HEALTHCARE 2020-02-07

"IP LECTRICAL PERMIT ALICATI N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION s PROJECT ADDRESS: /7g, ,v.VY e.e.Yl (J ay A-I: BUILDING AREA(if residential,new construction,remodel,or addition) y.'Ust) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 6C6MMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ /0-0-0 `�-- NUMBER OF DEVICES(if low voltage):, .1 FIRE ALARM? I YyES ID NO ASSOCIATED BUILDING PERMIT#(if applicable): e II g b i " 027 DESCRIPTION OF WORK: Ad told, . 1/7'/Oke ' c //WM eg. S7 vp je c-P-vir 77_ CONTACT INFORMATION OWNER NAME: -fes j' F CA,,e)1(. // 1/ NANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /7 �D 17[ Ce VL+" M i_)--e l w�- y Z.--1/-12A `.e,4'4 CITY STATE /4/4q ZIP / OWNER PHONE: L OWNER EMAIL: CONTRACTOR'NAME: 11-ex+-2_ Z-(-e c+\"-7(..w,. CONTRACTOR `?,ADDRESS: STREET "7 j/.6 n7 61— - 5.f l e‘,CQ VIM0.. CITY //tla STATE ep ksROP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): f z-g TZE 4c9z)3 k I CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ` PRIMARY CONTACT: 40 OWNER L f-NTRACTOR 0 OTHER(Please Specify) ..s,. CONTACT NAME: CONTACT PHONE: 2.06 ^ 141c -174 yd 1/A/Q—j O CONTACT EMAIL: '0U/1 vy'0$, '8 h o Ol 4ohm AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct Al provisions of laws and ordinances governing this type 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 local 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 1 PERMIT# --z�-1 1.50 — ( (3 Owner/ uthori -• -.en signature Date (Revised 90/92/2095)