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4ren- ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov( www.everettwa.gov/permits <br /> • • _..,... - • • :- : •• , PROJECT SITE INFOR,MA iON ' <br /> PROJECT ADDRESS: 3oo3 WEST CASINO ROAb EVEe7T WA 9t Z04 # -� ` _ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) kVA. SF <br /> BUILDING TYPE: ❑SFR-DETACHED El SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: Mp.t41..)FAC'TUts-11.1. <br /> ,. . : .- ". ELECTRICAL APPLIGIilTION::INFORMATION <br /> CONTRACT PRICE OF WORK'/gyp <br /> NUMBER OF DEVICES(if low voltage): MIA <br /> FIRE ALARM? 0 YES „C'NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): NA <br /> DESCRIPTION OF WORK: 7L'MPo'p.A.gy t S-•T W T70711 paws; a12hALC14 CIRCtQir mobtFICAT1A1LL <br /> 1-/GLE'E1Ak (ut~FO4-07J1e)REPLA•CeMm)T/IeF7JI2Bl.SNMm <br /> bEV(CE'(onlE-Fax.-o)JE,Ica-RAW/WENT .k / 117 AI..- GFGI 812EAKeZs <br /> U023--#324,3E <br /> ... . . . ;iliONTACT NFO1RMATION . . ..... .. .. . <br /> OWNER NAME: 45trelAta TENANT NAME(If Commercial): goveyAlter <br /> OWNER MAILING ADDRESS: STREET Pb 8Dic 3707 ��/ ��y <br /> cm, ....16744-7-Le STATE WA ZIP 98124-.220! <br /> OWNER PHONE:'/2.541.levo OWNER EMAIL: <br /> CONTRACTOR NAME: 4/gplyA•it 07.-E4-7-4./C,_ LLC- <br /> CONTRACTOR ADDRESS: STREET e�/5/35 /..J 9zAlb .STi12L-ET 1 <br /> CITY 1Aoy <br /> Mfb STATE Wil ZIP 1980,5.2 <br /> CONTRACTOR PHONE: 125. 8/4. 6000 CONTRACTOR EMAIL: cjaIN•lae(artSe Sec/466clb•Co1YI <br /> CONTRACTOR LIC.#(REQUIRED): 5EQUOEL 977.59 •CITY OF EVERETT•BUSINESS LIC.#(REQUIRED): '�O(o45 <br /> PRIMARY CONTACT: 0 OWNER t 2'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.2.251.z545 <br /> JIM ANbOILSotd� CzsWVER —FcjaEI44cM CONTACT EMAIL: _3;rn.aricte4 o n c 9 is tJd t• C.-am <br /> 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 <br /> of work will be completed whetherspec/lied 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 <br /> 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 <br /> comply with the Stale Contractors Law 18.27 RCW and 296.200 WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> GARY A 8 ER 15•2.2-.18 <br /> E k.SO% - lam ( <br /> Owner/Authorized Agent SignatureDate (Revised 9/23/2016) <br />