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WECTRICAL PERMIT AFOLICATION <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: 11114 Evergreen Way <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: MUItl-USe commercial <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ $2,500 <br /> NUMBER OF DEVICES (if low voltage): 2 <br /> FIRE ALARM? 0 YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Replace faulty FACP with new FACP and new Remote Annunciator. Equipment <br /> located in Razzal's Pub space. <br /> CONTACT INFORMATION <br /> OWNER NAME:Genesis Realty TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 18623 Hwy 99 <br /> CITYLynnwood STATE WA Z,P 98037 <br /> OWNER PHONE: 206-949.1776 OWNER EMAIL:4989genesls@gmall.Com <br /> CONTRACTOR NAME: Guardian Security Systems <br /> CONTRACTOR ADDRESS: STREET 1501 Kentucky Street <br /> ,,n Bellingham STATE WA z,p 98229 <br /> CONTRACTOR PHONE: 360.647.0110 CONTRACTOR EMAIL: amedawar@guardlansecurlty.com <br /> CONTRACTOR LIC.#(REQUIRED): GUARDSS233K5 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):003343 <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360.440.5.5518 <br /> Anthony Medawar CONTACT EMAIL:amedawar@guardiansecurity.Com <br /> 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 <br /> 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/ <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Anthony Medawar 26 May 2017 E 0 G5 lilt <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> i! 7 <br /> v <br />