9640 EVERGREEN WAY 2017-07-05 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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: 9640 evergreen way BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING, Gas Station ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: S 2500 NUMBER OF DEVICES If low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT# If applicable): DESCRIPTION OF WORK: replace(4)fuel dispenserv.0 new just pipe and wiring under dispensers no breaking of seal offs CONTACT INFORMATION OWNER NAME:S & S Petroluem TENANT NAME If Commercial:76 OWNER MAILING ADDRESS: STPEET CRY STATE ZIP OWNER PHONE: OWNER EMAIL CONTRACTOR NAME: Emerald Electric NW CONTRACTOR ADDRESS: sTRm9830 220th PL SE ,r,.SNohomish STATE WA 9 CONTRACTOR PHONE:4254461003 1CONTRACTOR EMAIL:Joey c@emeraldelectricnw. CONTRACTOR LIC. QUIRED: emeraen902dt CITY OF EVERETT BUSINESS LIC. RED:054282 PRIMARY CONTACT: 2 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4254461003 Joey Costello CONTACT EMAIL:Joey@emeraldelectncnw.co AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and coned. All provisions of laws and or6nences goveming this type of work will be completed whether speclAed hereto or not. The granting ore permit does nor presume to give authority to vldete or cancel the provlslans of any other state or twat law regulaling cornstrudion or the performance orconstrudlon. That I am authordzed by the owner of this property to perform the work for which appltcetlon Is made and I cwrplr with ft Stale Contractors Law 9E.27 RCW and 29&200 WAC. City of Everett Off=al Use Only PERMIT# bvvner horb gent Signature Date (Revised 9/23/2016)