10301 EVERGREEN WAY BASE FILE 2017-10-20

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: 10301 Evergreen WAY BUILDING AREA(if residential,new construction,remodel,or addition)1000 SF L.BUILDING TYPE: 0 SFR-DETACHED El SFR-ATTACHED 11 DUPLEX El MULTI-FAMILY-4 OF UNITS COMMERCIAL SE OF BUILDING: resturant ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1000 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 9 NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: CHANGING LIGHTBULBS IN SIGN. LIGHTING RETROFIT CONTACT INFORMATION OWNER NAME:SOUTH POINT PLAZA TENANT NAME(if Commercial): IHOP OWNER MAILING ADDRESS: ITRIE,406 ELLINGSON RD PACIFIC STATE WA 2,, 98047 OWNER PHONE: 1OWNER EMAIL: CONTRACTOR NAME: RVB ELECTRIC AND CONSTRUCTION CONTRACTOR ADDRESS: IT111,2803 GRAND AVE , EVERETT SWE WA ,, 98201 CONTRACTOR PHONE:4253449180 —[CONTRACTOR EMAIL- office@rvbelectric.com CONTRACTOR LIC.#(REQUIRED): RVBELVB841 M8 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):Q4� PRIMARY CONTACT: El OWNER 12 CONTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4259036834 JUL1YA GOLUB CONTACT EMAIL:OFFICE@RVBELECTRIC.COM 1= AGREEMENT I 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 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. Cityof Everett official Use only PERMIT# E Roq Owner/Authorized-A# nature Date (Revised 972312016) ...........