3625 BROADWAY STARBUCKS 2017-10-17

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: 3625 Broadway BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: IVCOMMERCIAL USE OF BUILDING: Starbucks ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2000.00 NUMBER OF DEVICES if low voltage): 3 FIRE ALARM? ❑YES 4f NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: Energy Management System, consisting of low voltage controller for HVAC Unit and Internet CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): Starbucks OWNER MAILING ADDRESS: STREET CIN STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: TLC Investments, LLC dba Stones River Electric CONTRACTOR ADDRESS: STREET 1244 Gallatin Pike South CITY Madison STATE TN ZIP 37115 CONTRACTOR PHONE: 615-885-0019 CONTRACTOR EMAIL: Iguye@stonesriverelectric.com CONTRACTOR LIC.#(REQUIRED): STONERE843J7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 236320 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 615-330-7833 Roger Edwards CONTACT EMAIL: redwards@stonesrlverelectric.Com AGREEMENT T hereby certify that 1 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 FEES ' n a PERMIT# C� c� E I to 0c2-1 -7 Owner/Authorized Agent Signature Date (Revised 10/1212015)