10121 EVERGREEN WAY OUTBACK STEAKHOUSE 2019-03-21

! ECTRICAL PERMIT APPLICATION 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 I www.everettwa.gov/permits PROJECT ADDRESS: 10121 evergreen way BUILDING AREA(if residential, new construction, remodel,or addition)3395 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: restaurant CONTRACT PRICE OF WORK: 17,000 NUMBER OF DEVICES (if low vItage): FIRE ALARM? 0 YES 'A NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: dining room, lighting remodel, loads reduced OWNER NAME: TENANT NAME(If Commercial): outback steak house OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: (OWNER EMAIL: »V CONTRACTOR NAME: R J CLARK LLC CONTRACTOR ADDRESS: STREET 19424 67TH AVE SE CIT. SNOHOMISH STATE WA LP 98296 CONTRACTOR PHONE: 206-510-8983 CONTRACTOR EMAIL: rjclarklIc@gmail.com gmaii.com CONTRACTOR LIC.#(REQUIRED): RJCLAL*981 MA CITY OF EVERETT BUSINESS LIC.#(REQUIRED)041260 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-510-8983 ROBERT CLARK CONTACT EMAIL: rjclarkllc@gmail.com AGREEMENT:I 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 I 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 PERMIT# /e66 - 1 ek /i3//8 E I ,Cb( Owner/Authorized Agent Signature Date (Revised 9/23/2016)