10200 19TH AVE SE 2017-06-07 - 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: 10200 19th Ave SE 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: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 23,000 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Change all existing exterior wall packs to LED. Change all existing pole light heads to LED. Removing 3 existing poles, and adding 4 new poles in the parking lot. CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): COStCO OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Staybrlght Electric CONTRACTOR ADDRESS: STREET 4468 Barnes Rd (,,N Colorado Springs STATE CO ZIP 80917 CONTRACTOR PHONE: 253-320-6126 CONTRACTOR EMAIL: ablackbp@sbeco.net CONTRACTOR LIC.#(REQUIRED): STAYBEC908RH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):050168 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify)_Adam- (253) 320-6126 CONTACT NAME: CONTACT PHONE: (2553) 320-6126 Adam Black CONTACT EMAIL:ablackbp@Sbeco.net 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 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 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016)