3003 W CASINO RD BLDG 40-05 2018-09-24

PLECTRICAL M.�. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-267-8857 1 (E) everetteps@everettwa.gov vwvw.everettwa.gov/permits PRO.DIECY SITS 1NF0RMA'PIOP➢ - PROJECT ADDRESS: D� 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: QE�14G EV�1L�-IT ELECTRICAL AF'PL�CATIOAI^IN ORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ANO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION. OWNER NAME: TENANT NAME(If Commercial): G OWNER MAILING ADDRESS: sTREEr 190 P7OX 3707 CITY LE' STATE W4 ZIP IZ "2207 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /7 Q GIC CONTRACTOR ADDRESS: sTREEr PO SOX CITY Mag /Z- 0 f STATIV ZIP ZD 1-1 CONTRACTOR PHONE: 5j-Z '7'�"t1 ` I 14 IC/ONTRACTOR EMAIL: hg/ . HAMME)Q 41 T-- 6041 CONTRACTOR LIC.#(REQUIRED): ��iV t��C �7 D Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O5 PRIMARY CONTACT: ❑OWNER w ®CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -Dl�-N w s 6P-ow CONTACT EMAIL: D ENN IS.CK014J LJ k1Q411 T, d—OM AGREEMENT,-Thereby certify that/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/ comply with the State Contractors Law 18.27 ROW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# E Own+uorlzed AgenSignature Date (Revised 10/12/2015)