2940 W MARINE VIEW DR CITRINE HEALTH 2019-02-11

I ILECTRQCAL PERMIIT AL I CAT1ON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 j (E) everetteps a@everettwa.gov l www.everettwa.gov/permits PROJECT ADDRESS: �Ctt10 /A)• /qaj J Vtu' DO-. BUILDING AREA(if residential,new construction,remodel, or addition) SF BUILDING TYPE: D SFR-DETACHED D SFR ATTACHED 0 DUPLEX D MULTi-FAMILY-#OF UNITS: 1,SCOMMERCIAL USE OF BUILDING: ( ✓ll • CONTRACT PRICE OF WORK:$ �, • 0,CQ NUMBER OF DEVICES(if low vol o ge): FIRE ALARM? D YES : 0 ASSOCIATED BUILDING PERMIT#(if applicable): L� DESCRIPTION OF WORK: t '� fA -4150 4tWLoY.. ��f2 i )N) 1i /h'r fp4,4 5 �Il� tft J CONTACTiNFORMATJON OWNER NAME: Ceu IH TENANT NAME(if Commercial): Cf 7.-0.4,41s �f� OWNER MAILING ADDRESS: STREET l `T' cny STATE zip OWNER PHONE: e n r OWNER EMAIL: CONTRACTOR NAME: R SVM G13c .r •.. :. .•.b ... ,. CONTRACTOR ADDRESS: STREET • 2�{Q� J • jPazAbg ony 7g(4 Y) 'J STATE VIA ZIPf: l• CONTRACTOR PHONE:. 6O ([ $$L� CONTRACTOR EMAIL: 44U(.4,4 MO 04 iste,rg.)G M CONTRACTOR LIG.#(REQUIRED): , /41 ODS .#(R D)= 5 CITY OF EVERETT BUSINESS LIC SQUIRE 783 PRIMARY CONTACT: El OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: I 1891 CONTACT EMAIL: 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 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 l am authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC City of Everett Official Use Only FEE H: c3so PERMIT# �z �.�-l�7 E l A2 - C4-22 l rlAutho ed Agent Signature Date (Revised 10/12/2015)