1818 PACIFIC AVE BASE FILE 2017-10-24

07/18/2017 16: 08 FAX 425 377 1976 REX ELECTRIC Z001 0) 0 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 4ffrr 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 P OJECT SITE INFORMATION PROJECT ADDRESS: BUILDING AREA Qf residential, new construction,remodel,or addltlon) $F BUILDING TYPr=: D SFR-DETACHED D SFR-ATTACHED ❑ DUPL- J MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: V @LECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES If low voltage)-,- FIRE olts eFIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMI # If applicable): DESCRIPTION OF WORK: t CONTACT INFORMATION OWNER NAME: T NANT NAME If Commerclal : OWNER MAILING ADDRESS: aTREET CITY tQ STATE Alk zip OWNER PHONE: b O OWNER EMAIL: CQNTRAgIOR ADD 111 T N Lake tevens258 STAT, ZIP GOtITRACTQR NE:425422-1744 R EMAIL: ks I QgNTRACTOR #(REXELg59Q2N4 ICITY OF EVE 8 L 040742-- PRIMARY CONTACT: rb OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Robin Riecks CONTACT PHONE :425422-1744 CONTACT EMAIL:alecks@gmall.coM AGREEMENT.T hereby carttry that l have r1Md end examinad INS oppticetion and know tha some io be hva and correct. All prvviaiona or levee end ordInances goveminp this typo of work will bo com*Md whetMr specMad hereln or not. The grandnp of a pemw does not presume to give authority to violate or cancel"provtalons or any other state or local law npulaft conshuation or the performance of constructfon. That l em autho izad by the owner of this property to perform the work for which app#cation 1S made end l comply with the State Contractors Law 18.21 RCW end 296.200 WAC. City of Everett OA'kJal Ude Only FEE Q I a5 CD PERMIT Ownor/A or x0 Agent Signa re Da (Revised 1(/12/2015)