3003 W CASINO RD BLDG 40-12 2018-09-24

_ECTRICAL PERMIT AP (CATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3003 WC4 19 q b $lam 40- 1-7, eVl�fW p VVA b�& 141�- BUILDING AREA(if residential,new Construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 11 SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: '�� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES IXNO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: t-TvA(�i G ka! W,-1-- U(_4k e�A �4 6r-- k CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial : OWNER MAILING ADDRESS: sTtxEET '31v CITY STATE VNIAr ZIP ` OWNER PHONE: dt�-J-S1z- 2I t$ I OWNER EMAIL: .M.SVJ'tA90 &04 S00-10lf7• LOM CONTRACTOR NAME: %i rItc- CONTRACTOR ADDRESS: sTREET 15135 aZ jo S CITY N STATEWA ZIP CONTRACTOR PHONE:�Zrj• �J`TS`1S CONTRACTOR EMAIL: • �til/gIS ug $� .(TI� GIaM CONTRACTOR LIC.#(REQUIRED):'b EGA 0 til. 1(o 6'k CITY OF EVERETT BUST E S LTC.#( QUIRE' - PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: AN o , 1-11-7 CONTACT EMAIL: Are-s,{, gCtAg W19."014 AGREEMENT:T hereby certify that t 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 t 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 298.200 WAC. City of Everett Official Use Only FEE PERMIT# E I WL, b� ow nt ignature Date (Revised 10/1212015)