3003 W CASINO RD BLDG 45-12 2018-09-20

O.ECTRICAL PERMIT AF`ILICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 00,3 (,(/, C�u.S /,-7 D Rd _ &57eZ -1 �� r'/Z S7i� f.6-175q- BUILDING AREA(if residential, new construction, remodel, or addition) l SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: MCOMMERCIAL USE OF BUILDING: P,41Vl,L ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES N(NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: ;��//(�C TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: N� 1 CONTRACTOR ADDRESS: STREET L'GLS L� J LOI.�r f n CITY STATE � ) ZIP CONTRACTOR PHONE: ,lq- CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED)A U ' 7.41/ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): d PRIMARY CONTACT: ❑ OWNER 13 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2� - ZZS- Sorel e CONTACT EMAIL: Gt✓lC L'r G'vlt'I ✓ fL'(�IVI S��,G'C� AGREEMENT:T hereby certify that I have read and examined this application and know the same tc e 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/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 PERMIT# Owner! uthorized Agent S4nature Date (Revised 10/12/2015)