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0 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: UBS Financial Services 1604 Hewitt Ave, 6th Floor, Everett, WA 98201 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 3,200 SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ®COMMERCIAL <br /> FSE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3,000.00 <br /> NUMBER OF DEVICES (if low voltage): 20 <br /> FIRE ALARM? ❑YES R NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Low Voltage Communications Cabling <br /> CONTACT II+fi1# RMATION <br /> OWNER NAME: TENANT NAME(If Commercial): UBS Financial Services <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Evergreen Technologies Inc <br /> CONTRACTOR ADDRESS: STREET 3623 East Marginal Way S <br /> CITY Seattle STATE WA zip 98134 <br /> CONTRACTOR PHONE: 06-774-1363 CONTRACTOR EMAIL: mcan@evergreentec.com <br /> CONTRACTOR LIC.#(REQUIRED): EVERGT1929K9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 050182 <br /> PRIMARY CONTACT: ❑OWNER I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: Meryem Can CONTACT PHONE: 206-774-1363 <br /> CONTACT EMAIL: mcan@evergreentec.com <br /> AGREEMENT:T hereby 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> 12/01/16 E �G( 2— <br /> Owner/Authoriz Agent Signature Date (Revised 10/12/2015) <br />