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411/ • <br /> 4ETT 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.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 811 SE Everett Mall Way <br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: m COMMERCIAL <br /> USE OF BUILDING: Retail <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 18,000 <br /> NUMBER OF DEVICES (if low voltage): 1 <br /> FIRE ALARM? 0 YES hNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install and maintain (1) new S/F illuminated wall sign on existing circuit for Olympic Hot Tub <br /> CONTACT INFORMATION <br /> OWNER NAME: Don Riling TENANT NAME(If Commercial): Olympic Hot Tub <br /> OWNER MAILING ADDRESS: STREET 811 SE Everett Mall Way <br /> ciTY Everett STATE WA ZIP 98208 <br /> OWNER PHONE: 206-286-0700 x3021 OWNER EMAIL:don@olympichottub.com <br /> CONTRACTOR NAME: City Lites Neon <br /> CONTRACTOR ADDRESS: STREET 902 NW 49th St <br /> c,Tv Seattle STATE WA Z,P 98107 <br /> CONTRACTOR PHONE: 206-789-4747 CONTRACTOR EMAIL: Sarah@Citylightssign.com <br /> CONTRACTOR LIC.#(REQUIRED): CITYLNIO99DG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):41415 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-789-4747 <br /> Sarah Terry CONTACT EMAIL:Sarah@citylightssign.Com <br /> AGREEMENT:I hereby certify that 1 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 /> PERMIT# <br /> E <br /> Owner/Aut oriz Age gnature Date (Revised 9/23/2016) <br />