4919 EVERGREEN WAY QFC 2019-09-05

OLT ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810 I FAX 425-257-8857 1 (E)everetteps©everettwagov 1 www,everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4919 Evergreen Way BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS 0 COMMERCIAL USE OF BUILDING: Grocery Store ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 3,800 NUMBER OF DEVICES it low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Wire for Deli Dept Remodel CONTACT INFORMATION OWNER NAME: QFC TENANT NAME cit Commercial): QFC OWNER MAILING ADDRESS: sTaEur 4919 Evergreen Way CT Everett STATE WA 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Boyer Electric Co Inc CONTRACTOR ADDRESS: sTREET 8119 240th St SW Edmonds STATE WA 98026 CONTRACTOR PHONE: 206 367-7606 CONTRACTOR EMAIL: karen@boyerelectric.com CONTRACTOR LIC.#4,REQUIRED}; BOYEREC101LE CITY OF EVERETT BUSINESS LIC.*REQUIRED): 22147 PRIMARY CONTACT: CI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 367-7606 Karen Hanson CONTACT EMAIL: karen@boyerelectric.com AGREEMENT I hereby certify that have read and e.amfned 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 1a27 RCW and 296 200 WAC. City of Everett Official use Only PERMIT# ) E 011 Owner/ thorized Agent Signature - Date (Revised 9123/20 I 6