12906 19TH AVE SE 2020-05-18 - Laserfiche WebLink

44-77 E CTRICAL PERMIT APF CATION CITY OF EVERETT PERMIT SERVICES i- In 3200 CEDAR STREET, EVERETT, WA 98201 ,,jvtLil I f� (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/perniNADVI / PROJECT SITE INFORMATION PROJECT ADDRESS: 12906 19th Ave SE BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: El SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Grocery Store ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 19,978 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES [?) NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Add/alter 10 circuits and supply and install 15 various fixtures, CONTACT INFORMATION OWNER NAME: Fred Meyer TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 12906 19th Ave SE cn. Everett STATE WA ZIP 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: SeaTac Electric, Inc. CONTRACTOR ADDRESS: STREET 7056 So 220th St CITY Kent STATE WA ZIP 98032 CONTRACTOR PHONE: 253-872-5553 CONTRACTOR EMAIL: dawn.lanz@seatacelectric.com CONTRACTOR LIC.#(REQUIRED): SEATAEI077RW CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 033037 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CO. � ,r� TACT NAME:DaUD1 CONTACT PHONE: 253-872-5553 CONTACT EMAIL: dawn.lanz@seatacelectric.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 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 properly to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 1 IVt Le /v1'3 : q ,`� , 1 E ;,100 -0?-7 Owner/Authorized Agent Signature Date (Revised 9/23/ 2016)