3003 W CASINO RD BLDG 40-31 2022-03-18

gay_ �30�. ECTRICAL PERM' IT APPL CATMN (P) 425-257-8810 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits 1PIR03ECT SITS INFORMAT1ON PROJECTADDRESS: 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: Q�T �46j EVeEETF ELECTRICAL APPLICATION lFORMATION CONTRACT PRICE OF WORK: $ INUMBER OF DEVICES (if low voltage): - IFIRE ALARM? ❑ YES ,TED BUILDING PERMIT # IDESCRIPTION OF WORK: MLS q"T 77._ INFORMATION,..: OWNER NAME: TENANT NAME if Commercial): G OWNER MAILING ADDRESS: p ,, STREET b 60)( 3 CIT7 Y STATE ✓ �// / .,q I2 '" 2207 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: t✓ ClC / /�-� CONTRACTOR ADDRESS: STREET PO TJD/X CRY M09/L 4 0sTAIM* ZIP / CONTRACTOR PHONE: �j"Z 7 "C�/ `t CONTRACTOREMAIL: CONTRACTOR LIC. #(REQUIRED): 19,eA/8,eC 4D z IGITY OF EVERETT BUSINESS LIC. #(REQUIRED): Q�OS PRIMARY CONTACT: ❑ OWNER ® CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: -Dl�-N N 15 C&) W CONTACTPHONE: Z�(Q-73b-(dS�t!p CONTACT EMAIL: a5 N 1!;. 6 .DW kig-vU l T. e-om AGREEMENT.- Thereby certify that/ have read and examined this application and Know the same to oe true ana correct ,vu provisions w iaws gnu uruo,dea yuvci„)„y u 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/ 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. Owner/Au onzed Agen Signature Date City of Everett Official Use Only FEE 5 (J a PERMIT # (Revised 1011212015)