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. 4rEn. <br /> OPECTRIC AL PERMIT APRICATION- <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.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> . <br /> PROJECT ADDRESS: 6000 23rd Dr W <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: © COMMERCIAL <br /> USE OF BUILDING: Office/WArehouse <br /> St,. .TR1CAt.. APPL.IC.ATION INFORMATION .` <br /> ( <br /> CONTRACT PRICE OF WORK $ 4500 <br /> NUMBER OF DEVICES (If low v Itage): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install (1) 100A 120/208v Sub Panel, Install (6) Equipment Connections/ <br /> REceptacles - Job #52789 <br /> CONTACT INPO.RMATI N <br /> OWNER NAME: TENANT NAME1If Commercial):Teague <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Pride Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET 18133 NE 68th Street, D-120 <br /> cm,Redmond STATE WA zip 98 <br /> CONTRACTOR PHONE: 425-454-3665 CONTRACTOR EMAIL: mbender@prideelectric.COm <br /> CONTRACTOR LIC.#(REQUIRED): PRIDEEI077DR CITY OF EVERETT BUSINESS LIC.#(REQUIRE 27137 <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑OTHER.(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-454-3665 <br /> Matt Bender CONTACT EMAIL:mbender@prideelectric.com <br /> AGREEMENT.I 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 I am 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 /> PER/Am' E MI IT# -dzg <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />