1605 SE EVERETT MALL WAY WALMART 2017-04-28

ECTRICAL PERMIT AF I LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1605 SE Everett Mall Way BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ® COMMERCIAL USE OF BUILDING: Comm - Retail ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1500.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES 43 NO ASSOCIATED BUILDING PERII�I IT# if applicable): DESCRIPTION OF WORK: Need an outlet installed for the new locker system that will be installed at a later date. CONTACT INFORMATION OWNER NAME: TENANT NAME(if Commercial): Wal-Mart OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Lin R. Rogers Electrical Contractors, Inc. CONTRACTOR ADDRESS: STREET 2050 Marconi Drive, Ste 200 CITY Alpharetta STATE GA ZIP 30005 CONTRACTOR PHONE: 770-772-7921 CONTRACTOR EMAIL: license@lrogerselectric.com CONTRACTOR LIC.#(REQUIRED): ECLINRRRR956B1 CITY OF EVERETT BUSINESS LIC.#(RE UIRED): 3� PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR El OTHER(Please Specify) Works for contractor CONTACT NAME: CONTACT PHONE: 770-772-7921 Ashley Walls CONTACT EMAIL: license@Irogerselectric.com AGREEMENT. Thereby certify that/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 granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# r Owner/Authorized Age Signature Date (Revised 10/1212015)