916 PACIFIC AVE BASE FILE 2017-10-30

WECTRICAL PERMIT A19LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits r_ PROJECT SITE INFORMAT -41 PROJECT ADDRESS:916 Pacific Ave BUILDING AREA(if residential, new construction, remodel, or addition) new construction SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL USE OF BUILDING:Commercial ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $715.00 NUMBER OF DEVICES if low voltage): 6 FIRE ALARM? ❑YES ❑✓ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: Install 2 card readers and 2 strikes and a 2 panels with 120v hook up. Titan Job 166236 CONTACT INFORMAT10 OWNER NAME—. Fairfax HoSpitar-- TENANT NAME(If Commercial):-F-akfax HoSpital OWNER MAILING ADDRESS: STREET 916 Pacific Ave city Everett STATE WA Z1P 98204 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Titan Electric, Inc. CONTRACTOR ADDRESS: STREET 12828 Northup Way Ste. 205 cin Bellevue STATE WA zip 98005 CONTRACTOR PHONE:206-633-2811 CONTRACTOR EMAIL:info@titanelectric.net CONTRACTOR LIC.#(REQUIRED):EC TITANE19630B CITY OF EVERETT BUSINESS LIC.#(REQUIRED): I PRIMARY CONTACT: []OWNER OCONTRACTOR ❑OTHER(Please Specify) 051191 CONTACT NAME: Elaia Wainright CONTACT PHONE:206-633-2811 CONTACT EMAIL:elaiaw@titanelectric.net AGREEMENT Thereby 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. City of Everett Official Use Only FEE �;j- nb�/ PERMIT# 1111/16 Owner/Authorized Agent Signature Date (Revised 10/12/2015)