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' Oterr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3200 <br /> CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:3003 West Casino Road(BLDG 40-82) <br /> BUILDING AREA(if residential,new construction, remodel,or addition)new construction SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING:Commercial <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WOR .$635.00/ <br /> NUMBER OF DEVICES(if low olta) .2 <br /> FIRE ALARM? OYES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install and terminate (2) CCTV Camerag.Titan job 166211 <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Company TENANT NAME(If Commercial): Boeing Company <br /> OWNER MAILING ADDRESS: STREET 3003 West Casino Road <br /> carr Everett STATE WA ZIP 98204 <br /> fWNFR PkfINF. IOWNFR FMAtU <br /> CONTRACT(1R NAMF•Titan Flectric <br /> CONTRACTOR ADDRESS: STREET 12828 Northup Waysuite 205 <br /> CITY Bellevue STATE WA ZIP 98005 <br /> CONTRACTOR PHONE:206-633-2811 CONTRACTOR EMAIL:info@titanelectric.net <br /> CONTRACTOR LIC.#(REQUIRED): EC TITANEI963OB 'CITY OF EVERETT BUSINESS LIC.#(REQUI 0):051191 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:EIaia Wainright CONTACT PHONE:206-633-2811 <br /> CONTACT EMAIL:elaiaw(aititanelectric.net <br /> 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> .��`-' ( /9b g/a''///� E <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />