8402 BROADWAY 2017-10-03 - Laserfiche WebLink

tLECTRICAL 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: 8402 Broadway, Everett WA 98208 Parcel#00393900601501 BUILDING AREA(if residential. new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS- M COMMERCIAL uSE OF BUILDING: Shell Gas Station & Food Mart ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2,000.00 NUMBER OF DEVICES (if low voltage): 4 @ 60w 12v LED drivers FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ®Wire new LED/FRN pole sign cabinet to existing electrical circuit: ®&®Wire 2 new LED illuminated Shell wall signs(1 on North canopy elevation&1 on South canopy elevation)to existing electrical circuits: CONTACT INFORMATION OWNER NAME: Shin In Bom TENANT NAME(If Commercial): Broadway Shell OWNER MAILING ADDRESS: STREET 8402 Broadway c7y Everett STATE WA Zip 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Insignia Sign Inc CONTRACTOR ADDRESS: STREET PO BOX 2849 CT,- Renton STAT` WA Z4P 98056 CONTRACTOR PHONE: (425)917-2109 CONTRACTOR EMAIL: steven@Inslgniasign.com CONTRACTOR LIC.#REQUIRED): INSIGSI055JS ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):G Q2_9 PRIMARY CONTACT: ❑OWNER [ACONTRACTOR ❑OTHER ,Please Specify) CONTACT NAME: CONTACT PHONE:. (425)917-2109 Steven Thomson @ Insignia Sign Inc CONTACT EMAIL: steven@Insignlaslgn.com AGREEMENT Thereby certify that I have read and examined this application and kno.r the same to be true and correct Alt 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 l am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE DZ r PERMIT#? gkve4t `11tanrlari (Contractor &Agent) 07/27/16 OwnerlAuthorized Agent Signature Date ;Revised 1 0/1 2120 1 51