6301 36TH AVE W BYRAM HEALTHCARE 2018-04-16

tit ECTRICAL PERMIT AF LICATION _ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE,INFORMATION PROJECT ADDRESS: 6301 36k" t v Par Mc (18ZO3 BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 4.COMMERCIAL USE OF BUILDING: 04 yy\ v\t ,tik-y, Aim ELECTRICAL APPLICATION INFORMATION." CONTRACT PRICE OF WORK: $ 2,/000 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): fin` DESCRIPTION OF WORK: Z neAk) �t' 1\t ct.kc p e.QY\ V VAS CONTACT INFORMATION" „t OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 01,5eY\ L CONTRACTOR ADDRESS: STREET 7 2 5 0.5!'1 _ S -`‘ CITY ,I e or\-- STATE ZIP can-i. CONTRACTOR PHONE:2S3 g7-2110,- CONTRACTOR EMAIL:rOJ,C.V1 ()1SCfitelC • CONTRACTOR LIC.#(REQUIRED): N.Ftei3( 9E- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER .02 NTRACTOR 0 OTHER(Please Specify) CONTACT NAME:ENNAMECONTACT PHONE: ZS'?; g7 Z( cj 0� c<UW [ 1tS C CONTACT EMAILQ base AGREEMENT:l 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 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 I 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 296.200 WAC. City of Everett Official Use Only PERMIT# ,,;•. � I � f0-i3 . 1 ? E \ - 1U2 Owner/1 - ��zed Agent Signature Date (Revised 9/23/2016)