7125 EVERGREEN WAY 2018-10-15 - Laserfiche WebLink

(P) 425-257-8810 �ECTRICAL PERMIT AP�ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PRQJECT SITE INFORMATION PRo.,ECT a��REss: 7125 Evergreen Way Everett WA 98203 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 Bui��iNc: Rodland Toyota ELECTRICAI. APPLICATION 1NfQRMATION CONTRACT PRICE OF WORK: $ 800 NUMBER OF DEVICES if low volta e: FIRE ALARM? ❑ YES � NO ASSOCIATED BUILDING PERMIT # if a licable : DEscRIPTION oF woRK: Replacing 1 existing fixture with LED C�NT,ACT INfQRIVIQTlON OWNER NAME: TENANT NAME (If Commercial): ROdlafld TOyOtB OWNER MAILING ADDRESS: srReET 7125 Evergreen Way �,N Everett STATE WA Z,P 98203 owNeR PHONe: 425-595-5510 OWNER EMAIL: coNTwacTOR NaME: Lumenal Lighting CONTRACTOR ADDRESS: sTReer 2� 7�6 66th AV@11U@ W@St c,n, Mountlake Terrace STATE WA Z,P 98043 CONTRACTOR PHONE: 425-4S1-5OO1 CONTRACTOR EMAIL: S@t'VIC@ 4�IUtl1@f1aI.COCT1 coNr�,cTOR �ic. #�REQuiRE��: LUMENLL864LW CITY OF EVERETT BUSINESS LIC. #(REQUIRED): #O524H6 PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 425-478-9464 DeWayne Simpson cotvTACT eMai�: DSimpson@lumenal.com AGREEMENT: 1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of /aws and ordinances governing this type of work wil/ 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 /aw regulating construction or the performance of construction. That 1 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. DeWayne Simpson OwnerlAuthorized Agent Signature 10-26-2016 Date City of Everett Official Use Only PERMIT # E l l�l D� ��d� (Revised 9/23/2016)