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477 IIECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov j www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 802 E Mukilteo Blvd, Everett WA 98203 <br /> BUILDING AREA(if residential, new construction, remodel, or addition)2500 SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ® COMMERCIAL <br /> USE OF BUILDING: Automated driveway gate system <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 4575 <br /> NUMBER OF DEVICES (if low voltage): 1 <br /> FIRE ALARM? ❑YES IZI NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): NA <br /> DESCRIPTION OF WORK: installation of LV automated gate system/ power by others <br /> CONTACT INFORMATION <br /> OWNER NAME: Forest Park Maintenance Yard TENANT NAME(If Commercial): Same <br /> OWNER MAILING ADDRESS: STREET 802 E Mukilteo Blvd <br /> c,T., Everett STATE WA L,p 98203 <br /> OWNER PHONE: 206-919-9332 OWNER EMAIL:jesset@formacc.com <br /> CONTRACTOR NAME: Automated Equipment Co. <br /> CONTRACTOR ADDRESS: STREET 10847 E Marginal Way S <br /> c,n Seattle STATE WA zP 98168 <br /> CONTRACTOR PHONE: 206-767-9080 x32 CONTRACTOR EMAIL: mike©aegates.com <br /> CONTRACTOR LIC.#(REQUIRED): AUTOMECO33RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 024872 <br /> PRIMARY CONTACT: 0 OWNER CC7 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206_919_9332 <br /> Jesse Trujillo CONTACT EMAIL:jesset@formaCc.Com <br /> AGREEMENT:I 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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Mike Pishue 10/26/16 Eb ` J DJ D2D <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />