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477. ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.evere vIr Q/o Pr s <br /> ... ...: :..::::.:.,:.,... .: ::... ...: ... *ECT.:SITE.INFORMATION.:;.`::::_::�:'; <br /> PROJECT ADDRESS: 6133 Lake Chaplain Rd. Monroe Wa. 98272 <br /> BUILDING AREA(if residential, new construction,remodel,or addition)Plant wide SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL <br /> USE OF BUILDING: Water Filtration Plant <br /> TO <br /> .O <br /> CONTRACT PRICE OF WORK:$ 200,000 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? li YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Annual Maintenance <br /> CONTACT INFORMATION <br /> OWNER NAME: COE TENANT NAME(If Commercial): Water Filtration Plant <br /> OWNER MAILING ADDRESS: STREET 3200 Cedar Street <br /> CITY Everett STATE Wa. ZIP 98201 <br /> OWNER PHONE: 425-257-8200 OWNER EMAIL: kmorman@everettwa.gov <br /> CONTRACTOR NAME: -Owner- <br /> CONTRACTOR ADDRESS: STREET 3200 Cedar Street <br /> cey Everett STATE Wa. ZIP 98201 <br /> CONTRACTOR PHONE: 425-257-8200 CONTRACTOR EMAIL: kmorman@eVerettWa.gOV <br /> CONTRACTOR LIC.#(REQUIRED): • CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: Pi OWNER 0 CONTRACTOR VI OTHER(Please Specify) Ken Morman <br /> CONTACT NAME: CONTACT PHONE: 425-257-8208 <br /> Ken Morman CONTACT EMAIL: kmorman@everettwa.gov <br /> AGREEMENT:!hereby certify that!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 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 <br /> local law regulating construction or the performance of construction. That lam authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 4/4/2017 E <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />