801 E CASINO RD 2018-09-06 - Laserfiche WebLink

tLECT ICAL PERMIT A41/4.1CATION -- 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 J www.everettwa.gov/permits PROJECT SITE INFORMATION • PROJECT ADDRESS: Sf'o ) c4 s;n o Rd / Eriert44 t ii C f n get C BUILDING AREA(if residential,new construction, remodel,or addition) /MO SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: C9rCey1 kdde,, ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ AJ 4 z„,„, /).1.)z) NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES PK; ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Di Scan ± 1E)e,,-4r;cR I Cei-v ce cor- tj fee..hint 0 Ind recd f•1+eC.+ a rin er exis'-i- ?teen Se ba c-t- - CONTACT INFORMATION ; OWNER NAME: Ev6re,44 cc6 i TENANT NAME(If Commercial): Lase #24 () OWNER MAILING ADDRESS: sTREEr 2222. Eve re.4/ 4 v COY E- +� STATE W A ZIP 9 r2.0 OWNER PHONE: 4 2 Sp- %2 7 'r OWNER EMAIL: v/V4 I f/fir- QL I/Ca-- S-, erf CONTRACTOR NAME: O,„v,f CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUI ): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lf 2,5-9 2_ 7� )� w v 1 rA / i Ile� CONTACT EMAIL: J Ai f )/ j- lie ec-t_k� pi o(2 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 is 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 lam 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 00 PERMIT# N iyvii tot., 7 -23 - 20I 7 C 7O7- l_ ,7 i—/ Ownei uthorized Agent Signature Date (Revised 10/12/2015)