2215 MERRILL CREEK PKY BASE FILE 2018-11-16

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 ( (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I rM ter"l f 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: q�Jt'S ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:S 14, 8 NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: n CONTACT INFORMATION OWNER NAME: b tti• TENANT NAME If Commercial): Z/ OWNER MAILING ADDRESS: STREET Y 2(�V&CnY V STATE ZIP OWNER PHONE: J— -5172A OWNER EMAIL: CONTRACTOR NAME:Rex Electric Service Inc. CONTRACTOR ADDRESS: 11112 18th ST NE Lake Stevens WA 98258 STATE ZIP CONTRACTOR PHONE:426422-1744 ICONTRACTOR EMAIL: rriecks mail.com CONTRACTOR LIC.# REXELES962N4 ICITY OF EVERETT BUSINESS LIC.#048749 PRIMARY CONTACT: S OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Robin Riecks CONTACT PHONE:425-422-1744 CONTACT EMAIL:rriecks@gmail.com 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 We 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � l� t I� PERMIT# E Ij 011 - 1115 Owner/Authorized Agent Signature Date (Revised 10/12/2015)