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3620 BROADWAY 2017-11-28
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3620 BROADWAY 2017-11-28
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Last modified
11/15/2017 1:46:12 PM
Creation date
11/15/2017 1:46:11 PM
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Address Document
Street Name
BROADWAY
Street Number
3620
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3200 CEDAR STREET, EVERETT, 8201 <br /> (P)425-257-8810 I FAX 42507-8857 I (E) everetteps@everettwa.govww.everettvva.gov/permits <br /> �(V PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: S632Broadway <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 3,800 SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: RI COMMERCIAL <br /> USE OF BUILDING: COMMERCIAL TENANT SPACE <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 40,000,00' 5O •OCJ <br /> NUMBER OF DEVICES (if low voltage): NONE BY R&S ELECTRIC <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 200 AMP OVERHEAD-TEMP SERVICE, BUTCDtNC <br /> - • , _• GH-TNG-ANE}POWER. <br /> CONTACT INFORMATION `/ <br /> OWNER NAME:VAN WINKLE PROPERTIES LLC TENANT NAME(If Commercial): �'cilt4 etir SOrkS �/G(120n <br /> OWNER MAILING ADDRESS: STREET Po F,Ox 5c$ <br /> CITY t vexe,-1--v 1 STATE VVI'\ ZIP O ao YJ <br /> OWNER PHONE: 42S-Sb%-IS 0(, INZS-1fol,-(00%co OWNER EMAIL: clCuf I UmcIOW{rS.CO(4 <br /> CONTRACTOR NAME: R&S ELECTRIC <br /> CONTRACTOR ADDRESS: STREET 18820 SMOKEY POINT BLVD SUITE B <br /> CITY ARLINGTON STATE WA ZIP 98223 <br /> CONTRACTOR PHONE: 360.659-1361 CONTRACTOR EMAIL: ddimascio@r-selectric.com <br /> CONTRACTOR LIC.#(REQUIRED): RSELE**022QZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 034455 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.268-2013 <br /> DAN DIMASCIO CONTACT EMAIL:ddimascio@r-selectric.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 I <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> /01/3 //7 E 17(o - ! zg <br /> Owner/Au horized Age t Signature Date t (Revised 923/2016) <br />
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