11311 19TH AVE SE BLDG G 2025-09-30

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits .,PRQ.IECTlTEINFORM PROJECT ADDRESS: 11311 19th Ave SE Everett, WA. 98208 , Building G BUILDING AREA(if residential,new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: Apartments ELECTRMCAL AP�IJ�ATION;.�I�IQ11A,I�TMQti� . CONTRACT PRICE OF WORK:$ 480 a NUMBER OF DEVICES (if low voltage): 1 FIRE ALARM? ❑YES ONO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Extend 20amp circuit and add outside light fixture r k x CONTACT tNFdRNfATIQN t OWNER NAME: Bluwater Apartments TENANT NAME(If Commercial). Amber OWNER MAILING ADDRESS: sTREET 11311 19th Ave SE if CITY Everett STATE WA 98208 ., OWNER PHONE: 425-357-8400 OWNER EMAIL: I 1= CONTRACTOR NAME: Active Engineering/Neighborhood Electric CONTRACTOR ADDRESS: sTREET 6605 200th St SW c rr Lynnwood STATE WA ZIP 98036 I f CONTRACTOR PHONE: 425-776-8119 CONTRACTOR EMAIL: admindesk@activeengineering.net CONTRACTOR LIC.#(REQUIRED): ACTIVE"088MS ICITY OF EVERETT BUSINESS LIC,#(REQUIRED): 026248 PRIMARY CONTACT: Q OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-357-8400/206-571-7965 ,AMBER / LUCAS CONTACT EMAIL: 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 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 l comply with the State Contractors Law 18.27 RCWand 296.200 WAG. C u ti 4 City of Everett Official Use Only l PERMIT# Owner/Authorized Agent Signature pate (Revised 9!2312016) 7 i a