9520 EVERGREEN WAY 2017-06-20 - 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: 9520 Evergreen 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: Fire Station ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 5852.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES m NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Fuel Card reader replacement and circuit modifications CONTACT INFORMATION OWNER NAME: City of Everett TENANT NAME(If Commercial): Fire Station # ' OWNER MAILING ADDRESS: STREET 3200 Cedar St cin Everett STATE WA ziP 98201 OWNER PHONE: 425-257-8920 OWNER EMAIL: CONTRACTOR NAME: Innovative Electric, Inc CONTRACTOR ADDRESS: STREET P. O. Box 4399 ciT,, Everett STATE WA z.E 98204 CONTRACTOR PHONE: 425-290-7803 CONTRACTOR EMAIL: gunnar@Innovative-electrlc.Com CONTRACTOR LIC.#(REQUIRED): INNOVEI055KE CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 36828 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-290-7803 Gunnar Petzold CONTACT EMAIL: gunnar@innovative-electric.com AGREEMENT.1 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 PERMIT# �� - E `jD�- Oq Owner/Authorized Agent Signatu Date (Revised 9/23/2016)