2930 MAPLE ST GROUP HEALTH 2018-11-13

.��°TRIC�4L ��Rf�l°T �4� LIC�4T'ION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everetiwa.gov � www.everettwa.gov/permits - PROJECT SITE INFORMATIOM PROJECT ADDRESS: �, (' � 7L� �"j�� ( 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: M,� I��L(�1� 'L,�y�J�L ELECTRICAL APPLICATION II�iFORMATION u� CONTRACT PRICE OF WORK: $ �Q�(� --- NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: `C,��y� O � �- C� (� (��., CONTACT INFORMATION OWNER NAME: ^L -, � TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srtzeeT CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: � CONTRACTOR ADDRESS: sTReeT �'�� I � (�U CITY � � STATE �' 'j� Zlp �v _ `� CONTRACTOR PHONE: '7,_ CONTRACTOR EMAIL: �C,(rvL � C CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BU51NES5 LIC.#(REQUIRED): . ' _ 3$ PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.�T hereby ce�tify that I have�ead and examined this application and know the same to be frue and correct. All provisions of laws and ordinances govemrng this fype of work will be completed whether specified herein or not. The g�anting of a permit does not presume to give authority to violate or cancel the provisions of any other state or /ocal law regulafing const�uction oi the performance of consf�uctron. That l am authorized by the owner of this property fo perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everetf Otficial Use Only FEE � `��2 � PERMIT# � �� `� E 1 (�0�--I �,"1 Owner/Authorized AgenE Signature Date (Revised 10/12/2015)