3003 W CASINO RD BLDG 40-58 2023-06-16

"" •LECTRICAL PERMIT A•LICATION 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) www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: � n > C �S I J) 0.._ 1 1 J�6� �O �L r(1 G c) BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 431 COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 3 .). NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES 1E00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: r1 f Q \"T' C�\ I� �J `�) C fill O GN if) Q1 �kc",-,C7�) c U-�C , 11(I�\ Li ��x� (J lnv OM 1/� te,e d . CONTACT INFORMATION OWNER NAME: —\ I\Z. &t\n% Cc c 71-rA' TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �_ � G� (rS I,,-,J d CITY t v -. STATE V j Q ZIP 1 2 J OWNER PHONE: fill OWNER EMAIL: CONTRACTOR NAME: d\1 c's)1 , •S\ ,-,C.G,C6 Q.'s _LY17;6 4( 1 C.�\ Lot L CONTRACTOR ADDRESS: STREET _./1 Lj ' .6>� Cj).f Q e.._, CITY VQ_(`'Z i STATE \ IN zip !j,,,,o CONTRACTOR PHONE: ,-L./24 --2 .9-2 - P_,c7 a CONTRACTOR EMAIL: . v -YciA`.' P t>Q\--' Co 1-5--, CONTRACTOR LIC.#(REQUIRED) &(\) � 1 cic'1 \�c-) CITY OF EVERETT BUSINESS LIC #(REQUIRED) (--2,c 2---) PRIMARY CONTACT: :AZT-OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: j),S _ 7S L _ J Cio - V 1 } )2 VS )C' r CONTACT EMAIL: vONy_ K.1 �� i\t) .- _C.INSN AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All 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 l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE t �r70 PERMIT# Owne th6r1ied Agent Signature Date (Revised 10/12/2015)