120 SE EVERETT MALL WAY BLDG 13 2020-02-04

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE,INFORMATION PROJECT ADDRESS: 120 southeast Everett mall Way 6 BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX m MULTI-FAMILY-#OF UNITS: 8 ❑COMMERCIAL USE OF BUILDING: Bldg 13 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 2,150.00 NUMBER OF DEVICES if low voltage): 1 FIRE ALARM? m YES ❑NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: Replacing fire alarm panel CONTAC"`r,--#WF6*MATtt)N OWNER NAME: Fultons Crossing TENANT NAME(If Commercial): OWNER MAILING ADDRESS: 3-RECT 120 SE Everett Mall Way Wy Everett, WA 98208 STATE WA ;,p 98208 OWNER PHONE: 4253480737 1OWNER EMAIL: FultonsCrossingMGR@pinnacieliving.com CONTRACTOR NAME: Innovative Systems Tech, Inc CONTRACTOR ADDRESS: S,RE.T 1402 Lake Tapps Pkwy SE Ste 104-147 CITY Auburn STATE WA 98092 CONTRACTOR PHONE: 2538911226 CONTRACTOR EMAIL: theoffice@innovativesystemstech.com CONTRACTOR LIC.#(REQUIRED): Innovst881 B$ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253891 1226 Mark Jensen CONTACT EMAIL:theoffice@innovativesystemstech.com AGREEMENT 1 hereby certify thatl have read and examined this application and know the same to be true and correct_ All provisions of tams 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 perforin the work for which application is made and I comply with the State Contractors taw 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# �- - �� E Owner/Authori d Agent Signature Date (Revtsed 9/23/2016)