6301 36TH AVE W MIIR HOLDINGS 2018-04-16

OLT ECTRICAL PERMIT AILICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4,362sjz36714 AMIE (S14 10 BUILDING AREA(if residential,new construction,remodel,or addition) 4704CID SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: %COMMERCIAL USE OF BUILDING: ADjLjf E. OrF, ELECTRICAL APPLICATION INFORMATION, CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): /,5 FIRE ALARM? 14YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ,4i 4j yt Phc3D<PSGA71 YJ.1 CONTACT INFORMATION OWNER NAME: J(,,Na fz yvt I L L PH 1. TENANT NAME(If Commercial): ►V t i I V,,vi OWNER MAILING ADDRESS: STREET 4,940 le.7j.t7- 1.014Y SSS CITY A r�rrzz STATE WA ZIP 9S 13S OWNER PHONE: ppB� OWNER EMAIL: CONTRACTOR NAME: i4�'-Dy GLEG772/ '� CONTRACTOR ADDRESS: STREET 1/212.6 /g - Atc.43 or/0 f CITY 1 1314 R STATE /AN* ZIP dC? j CONTRACTOR PHONE: 255-21,59—2600 CONTRACTOR EMAIL: 544057.1La iLt 12$ CONTRACTOR LIC.#(REQUIRED): K1 Ralf Z(2)-770'4 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): / P a a PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 25'5 .639- VzS )E 14# A4 CONTACT EMAIL: SA44607.1ice' �Lgen2 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 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 FEE rooms PERMIT# �� l� E 11'05-00 Owner Authorized Agent Signature Date (Revised 10/12/2015)