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12906 19TH AVE SE 2019-06-06
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12906 19TH AVE SE 2019-06-06
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Last modified
6/6/2019 3:37:58 PM
Creation date
1/10/2017 1:25:06 PM
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Address Document
Street Name
19TH AVE SE
Street Number
12906
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� <br />• <br />• <br />11:50:24 08-19-2014 3J3 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEl", EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />12906 Bothell-Everett Highway (Mill Creek) <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Fred Meyer 12906 Bothell-Everett Highway <br />Tenant Mail Address <br />Cochran, Inc. 7550 SW Tech Center Drive #220 <br />Electrical Contractor Mail Address <br />COCHRI`088JS <br />Sfate License Number <br />Proposed Use of Building <br />City <br />Everett <br />City <br />Tigard <br />City <br />Square Footage (If residential new construction, remodef or addition) <br />Number of devices (lf low voltage) <br />State/Zip Phone <br />WA 98208 425- 398-7000 <br />Stale/Z!p Phone <br />OR 97223 971-205-4242 <br />State/Zip Phone <br />$1,000.00 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: W013750 PM610 NWMG Fred Meyer Disconnect / Reconnect Cheese Case <br />Site Contact - Brian Sturdevant - 971.271.4477 <br />FEE <br />C1TY OF EVERETT LOCAL SALES TAX CODE fS 3105 ��� i O <br />I hereby certify fhai I have read and examined this application and know the same to be true and 7 <br />correcf. All provisions of laws and ordinances goveming this type of work will be completed <br />whether speci�ed herein or nof. The granfing of a permit does nof presume to give authority io pERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or ihe <br />performance of construction. Thaf 1 am authorized by the owner of this property to perform the E��� �-- ��� <br />work for which application is made and I comply with the Sfate Contractors Law 18.27 RCW and <br />296.20 WAC. <br />Please charge credit card <br />��q /��--• on file - ends 0908 <br />., ignature Date � <br />Please email copy of permit & receipt to portlandpermits@cochraninc.com / Electrician will pick up originals at counter <br />REVISED 3�10/13 <br />
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