4301 HOYT AVE WESTERN WASHINGTON MEDICAL GROUP 2023-04-03

��ic�� n�i� ��c��io� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJEGT SITE INFORMATION PROJECT ADDRESS: y ` �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 BUILDWG: �,�� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ � UD � � C� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES �NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: (ilr� C� q � h CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): l,✓t$�ry� S • OWNER MAILING ADDRESS: sTReEr m'�" ��'� � CfTY STATE ZIP OWNER PHONE: OWNER EMAIL: _. _. CONTRACTOR NAME: Od� l LCC CONTRACTOR ADDRESS: srReEr �SY2� 7� �� CITY K �[G{ STATE ZIP /`�"o' �0 J , CONTRACTOR PHONE: 6— �S CONTRACTOR EMAIL: R •� � tei�. CONTRACTOR LIC.#(REQUIRED): Q�D/�-�G�S.S CITY OF EVERETT BUSINESS LIC.#(REQUIRED):S�/ PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: S�- 2S . � CONTACT EMAIL: �, r� � AGR EMENT. T hereby certify that I have read and examined this application and know the same to be true and correct. All provisrons of laws and ordinances governing this type of work will be completed whether specified l�erein o�not The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or locallaw regulating construction or the performance of consfruction. That l am authorized by the owner of this property to perform fhe work for which application is made and l comply with the State Contracfors Law 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE `� ��,�� PERMIT# /-1�'�? E I O " �� Owner/Authorized Agent Signature Date (Revised 10/12/2095)