5415 EVERGREEN WAY COASTAL COMMUNITY BANK 2017-01-13

� �J �� �ECTRICAL PERMIT AF�LICATION F CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits ELECTRICAL APPL�GAT�QN IN'FORMATION CONTRACT PRICE OF WOF2K: $ $2450.00 NUMBER OF DEVICES if low volta e: FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT # if a licable : �EscRiPrioN oF woRK: Mechanical controls for Tenant improvement on part of first floor C��ITAC'T` i1�If�RMATIQt� OWNER NAME: COaStal COC1lIllUCllty BaC1IC TENANT NAME (If Commercial): N//� OWNER MAILING ADDRESS: sTREeT �,n Everett STATE WA Z,P 98203 OWNER PHONE: OWNER EMAIL: N�A CONTRACTOR NAME: MBE EleCtflC LLC CONTRACTOR ADDRESS: srReeT 12002 SE 91 st ST �� Newcastle STATE WA Z�P 98056 CONTRACTOR PHONE: 253-33Z-4O72 CONTRACTOR EMAIL: ►'pb@gI@Ctl'IC hotmail.com coNrRacTOR �ic. #�REQu�RE��: MBEELEL8740Q CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 05356H PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 2rj3-332-4072 Mike coNTacr ennai�: mbeelectric hotmail.com AGREEMENT: T 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 grantrng of a permit does not presume to give authonty to violate or cancel the provisions of any other state or local law regulating construction or the pertormance 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 Confractors Law 18.27 RCW and 296.200 WAC. MicG�aG �r�ccG� 07/06/2016 Owner/Authorized Agent Signature Date City of Everett Official Use Only FEE PERMIT # E� � �� . � � (Revised 10/12/2015)