801 E CASINO RD 2019-06-10 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION /11IPP:4%/. 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( www.everettwa.gov/permits n P:140.lECT SITE 1F100: : 14)0 C r u _ � '�� . ._s a ��,�.�,�. mow* �m�..�,�� ,�„� PROJECT ADDRESS: S } eV ,pA 01 t BUILDING AREA(if residential,new construction,remodel,or addition), rah / -- SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1 IrCOMMERCIAL USE OF BUILDING: S al U0 1 '-” l.0l5 C gat,t,. HI 41 (SCM 0.0) t '': E E TMO:4 ptKrLOOV:Na ,ORMACIQN " CONTRACT PRICE OF WORK:$ 2.- OLX) NUMBER OF DEVICES(if low voltage): ` FIRE ALARM? 0 YES /NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 5+01.1111 UY\ i4—' 4701. ( s- -1 r,t ha ac 1 1 s i rC Lf vim, gti-x iCONTACT INFORI 14.1 ON 4 iz` nE r OWNER NAME: tv6Vet A 4 uo4 ( tic V TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 30)tX) Byrn.61 !`i' , ...- CITY r v Vt fF STATE lAjil ZIP OIRd0 3 OWNER PHONE: 10\2_( - 3S `i U)0 OWNER EMAIL: CONTRACTOR NAME: S , 1 ( f-f C( m Um j( on s CONTRACTOR ADDRESS: STREET 1)-4.2o2... t ever 1 j pp) L IT (QTY ` VY. . STATE LA,4 zIP Cl POI) `-" " CONTRACTOR PHONE:10'126- '6I 0) 3 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): S iLy 7 C I Cl 'ID-j Q1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 01-1/p9-7 PRIMARY CONTACT: D OWNERCONTRACTOR 0 OTHER(Please Specify) CONTACT mayZ , NAME: / CONTACT PHONE: L 65.---1 5 . 6 v-i o C' 1 i}.0 1 CONTACT EMAIL: c/ c , (01,u,J{ /° S IIIc yhu ii( it°�- l, AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct.1)!provisions IV and ordinances governing this we net 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!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 PERMIT# / 1/1 . V-----1--- ir Owner/Authorized Signature Date (Revised 9/23/2016)