1019 112TH ST SW 2017-06-07 - Laserfiche WebLink

LECTRICAL PERMIT � PLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFo*M*ftN PROJECT ADDRESS: 10 19 112th St. SW, Everett, WA 98204-4875 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: Medical ''ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK 3279.70 NUMBER OF DEVICES if low olta e : FIRE ALARM? ❑YES m NOS ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: REMOVE AND REPLACE 36LIKE-IN-KIND 12V UPS BATTERIES IN CABINET. ALL EXISTING CABLING WILL REMAIN THE SAME, NO CHANGES TO LOAD OUPUT OF UPS. CONTACT INFORMATION OWNER NAME: Jon Tomberg TENANT NAME(If Commercial): Community Health Center OWNER MAILING ADDRESS: STREET PO Box 13060 cin, Everett STATE WA ZIP 98206 OWNER PHONE: 425.789.3737 OWNER EMAIL:Jtomberg@ChCsno.org CONTRACTOR NAME: EATON CORPORATION CONTRACTOR ADDRESS: STREET 13205 30TH ST SE, SUITE 101 clTv BELLEVUE STATE WA ZIP 980Q CONTRACTOR PHONE: 509.347.6308 CONTRACTOR EMAIL: TRAVISJOHNSON@EATON.COM CONTRACTOR LIC.#(REQUIRED): EATONC*844D1 ICITY OF EVERETT BUSINESS LIC.#(REQUIRE ): 056707 PRIMARY CONTACT: 10 OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425,789.3728 Shane Hall CONTACT EMAIL: shall@ChCSno.org 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 I 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 Digitally signed by Johnson,Travis J PERMIT# ' r Johnson, Travis J DN:cn=Johnson,Travis C Date:2017.04.12 13:29:30-07'00' C I v Owner/Authorized Agent Signature Date (Revised 9/23/2016)