7404 EVERGREEN WAY EDEN CLINIC 2019-02-05

N.ECTRICAL PERMIT AF LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7.4-e4 C6 V �� 1-47 -fr �.. BUILDING AREA(if residential,new construction, or additioryl SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: LS'COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ /40' °2.-2 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: S'ji1 CtivAn -el L 4r2 CONTACT INFORMATION OWNER NAME: TA "T" " 1- y TENANT NAME(If Commercial): tr( C OWNER MAILING ADDRES STREET ( 3 B 26 f2—i CITY -'IL Cr-re 1� STATE f 444 LP �f7 O +� OWNER PHONE: —418 .2sT ? OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET /'/%J6 14Lvr A CITY L i vtWriea STATE 14,, ZIP '6-636 CONTRACTOR PHONE: 4 2. 27 009 CONTRACTOR EMAIL/Gimes Q c ly --c - c, f,i v C7 t) CONTRACTOR LIC.#(REQUIRED): c* z3 57 CITY OF EVERETT BU (NESS LIC.#(REQUIRED): tS �� 20 PRIMARY CONTACT: 0 OWNER CON � (J J OR 0 THER(Please Specify) CONTACT NAME: Pi/tr CONTACT PHONE: %L, 3 -0®9+ `IAril•e$ CONTACT EMAIL: /AGREEMENT:!hereby certify that Iad and examined this application and know the same..ty a true and correct. All kovisior(of laws ea 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 perforin 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 PERMIT# Q /-2 --k 0 OwnerlAutho zed Agent Signature Date (Revised 9/23/2016)