2 W CASINO RD 2016 BLDG A 2020-02-20

�ECTRICAL PERMIT AI LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ZV�J ,P/1r �j( G f� BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX I'�,MULTI-FAMILY-# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: �J�P�y ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ GI2� ,S � NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES NO � ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: -e ��j �!/� �/L�- h (/�C� CONTACT INFORMATION OWNER NAME: �{jQ„ TENANT NAME (If Commercial): 1 OWNER MAILING ADDRESS: srREeT CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �� G CONTRACTOR ADDRESS: srReer �yif Zj�' C !9(-tl�- � CITY STATE ZIP ` CONTRACTOR PHONE: Z�b , �j,S . Q'U CONTRACTOR EMAIL: G��(ll�Z • C�-- CONTRACTOR LIC. #(REQUIRED): �9OZ 363 !� 3 CITY OF EVERETT BU5INESS LIC. #(REQUIRED): �� 2i� _ _. _ _ _ _ _ PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: !�-y�' .� � •�S� S CONTACT EMAIL: � L , C�P—�--� AGREEMENT: T hereby certify fhat l have read and examined this application and know the same to be true and correct. Al/ provisions of laws and ordinances goveming this type of work will be completed whether specified he�ein or not. The granting of a permit does not presume to give authorify to violate o� cancel the provisions of any other state or local law iegulating construcfion 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. Owner/Authorized Agent Signature Date City of Everetf Official Use Only FEE �'�o- �� PERMIT # E ( (� 0 Z � � � �Z (Revised 10/12/2095)