1 W CASINO RD 2017-08-17 - Laserfiche WebLink

i ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES i 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits ....... MI� CRM/ TN., n PROJECT ADDRESS: I West Casino Road BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL R USE OF BUILDING: Church (, N Wil; .... P.. WTRPL�CA'110111,=1N Q M `fT�OX!1, CONTRACT PRICE OF WORK: $ 1400 NUMBER OF DEVICES (if low voltage): g� P FIRE ALARM? ❑YES m NO g" f ASSOCIATED BUILDING PERMIT# if applicable): ; DESCRIPTION OF WORK: Replace conductors at service entrance F i tl b I j .:CO . TAC 110 wkTION OWNER NAME: TENANT NAME(if Commercial): South Everett Community Church OWNER MAILING ADDRESS: STReEr 1 West Casino Rd CITY Everett STATE WA ... 98204 OWNER PHONE: 425-353-2719 OWNER EMAIL: i CONTRACTOR NAME: Active Engineering/Neighborhood Electric CONTRACTOR ADDRESS: STREET 6605 200th St SW CITY Lynnwood STATE WA ZIP 98036 CONTRACTOR PHONE: 426-776-8119 1 CONTRACTOR EMAIL: admindesk@activeengineering.net CONTRACTOR LIC:#(REQUIRED): ACTIVE*088MS ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 026248 PRIMARY CONTACT: Q OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-327-8741 Billy Kroeze CONTACT EMAIL: 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. t 2 City of Everett Official Use Oniy PERMIT# Owner/Authorized Agent Signature Date (Revised 9123/2016)