6000 23RD DR W TEAGUE 2016-11-15

��I�� .�� I��'�� CITY OF EVERETT PERMIT SE VICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits � PRO.IECT SITE IWFORMATIOP�1 PROJECT ADDRESS: � U UCJ 2 3 �Z1� � � J^ BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: COMMERCIAL USE OF BUILDING: G��l C.� � C�.� �-�L� l-j��'� j� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ Z C) �� NUMBER OF DEVICES (if low voltage): ZS� FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: ^,q L ' � � � � ,2 � � C�{.r �p • C. C� � ' CONTACT INFORMATION .� OWNER NAME: TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTREEr CI71' STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �''�' (.� C; N'T ^' vJ O'� Ii L L- CONTRACTOR ADDRESS: sTREeT �O � ILA� � S�'� �"v � CITY 'L N STATE � ZIP ZZ � CONTRACTOR PHONE: �(Q U• (q(� - % Z CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): D� �/ lU PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 2p(D —�� _ ?� ��- �Sc� � �—•� 'v�� 2 j� CONTACT EMAIL: '�-� r1L. c�!/c" � "' ' q � /U -•—�✓��iZK� � �``" AGREEMENT.' T hereby certify ihat I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be comp/eted whether specified herein or not. The granting of a permit does nof presume to give authonfy to violate or cancel the provisions of any other state or local law regulating consiruction or the performance of consfruction. That I am autho�ized by the owner of this properfy to perform the work for which applicatron is made and I comply with the State Contractors Law 1827 RCW and 296.200 WAC. Own Signature Date City of Evereff Offrcial Use Only FEE �� U `� � .�� . PERMIT # E�! �i� --�� (Revised 10/12/2015)