3003 W CASINO RD BASE FILE 2023-12-06

OE14E 7 ERMT PPLA CITY TRIC OF EVERETT PERMIT SERVICES 3200 CEDAR STREEP , EVERETTITA , WA 98201IC TION (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3003 W Casino Rd., Everett WA 98203 (APN #28041000100200) BUILDING AREA(if residential, new construction, remodel, or addition)Sitewide SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL USE OF BUILDING: Manufacturing, Assembly & Office ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 286,000 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES m NO ASSOCIATED BUILDING PERMIT# (if applicable): N/A DESCRIPTION OF WORK: Electrical work to be performed by Boeing labor (Facilites & Asset Management). All contractor work to be performed under separate permits. CONTACT INFORMATION OWNER NAME: Boeing Company (Todd Haberlack) TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET P.O. Box 3707 M/S OH-13 CITY Seattle STATE WA ZIP 98124-2207 OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlack@boeing.com CONTRACTOR NAME: Owner CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-260-2668 Todd Haberlack CONTACT EMAIL: todd.j.haberlack@boeing.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 property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 543 /9 E �� -- ner/Authorized Agen Signature Date (Revised 9/23/2016)