11400 EVERGREEN WAY 2019-09-06 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION 1111 _ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION ; .. PROJECT ADDRESS: 1IaDQ 14 j �' ) 1 Et�t>..Ce..-1.4 i Vja-982Ll BUILDING AREA(if residential,new cons ruction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Commercial ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ (,,3 1p NUMBER OF DEVICESif low voltage): FIRE ALARM? ID YES El NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ' ' ' i► i,a, ^ .* 1 :,:x dim. i:recepfitte,A r.> ll_ CONTACT INFORMATION OWNER NAME: TENANT NAME If Commercial): _____l OWNER MAILING ADDRESS: STREET 702 `,J s1E0, S(1-16J CinHenfc&ilt STATE AR.. ZIP -707 it 4 OWNER PHONE: --gC 7- a - OWNER EMAIL: CONTRACTOR NAME: Lin R Rogers Electrical Contractors Inc CONTRACTOR ADDRESS: STREET 2050 Marconi Drive, Ste 200 cm,Alpharetta STATE GA zip 30005 CONTRACTOR PHONE: 770-7723472 CONTRACTOR EMAIL: License@LRogersElectric.com CONTRACTOR LIC.#(REQUIRED): EC LINRRRR956B1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051310 PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 770-77245M5 5 Amanda Lee • CONTACT EMAIL:License©LRogersElectric.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 pennit 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# ,r 40—Q--)st(\,/ E Owner/Auth•rized Agent Signature Date . (Revised 9/23/2016)