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OCT-17-2017 12:30 FROM-AC ELECTRI� 2538135817 �AIT-T5;�w'001/001 F-219 <br /> ' �► P�RMIT APp�I � � �• <br /> ELEC,TRIC L <br /> ClTY OF EV�R�TT P�RMIT S�RVICES <br /> 3200 CEDAR S�'R�ET, �V�RETT, WA 98201 <br /> (P}425-257-881� � FAX 425-257-t3857 ( (E)everetteps@everettwa.gav � www.everettwa.�ov/permits <br /> PFt!Q.���1° �1�T� Id�RQ��HIATIOM � ' <br /> PROJ�CT AD�}i�SS: Sc"]'F@Wa #1484 - 4�l 28 Rucker Ave E Everett, WA 98203 <br /> �LIILDING AREA(d fesjt�efttial, new construction, rEmodel,or addition)1 QOO SF <br /> �UILDING TYPE: ❑ SFR-P�TACHED Q SFR-ATTACHED ❑ DIJPL�X ❑MU�71-FAMILY-#OF UNITS: 0 COMM�RCiA� <br /> us�oF aui�RlN�: <br /> ���cTRii���. APP�.#��"���N ���o��nA��r�t� <br /> CONTRACT PR1C�OF WORK: $ 2000 <br /> NUM�3ER�F p�VICES if low volta e : <br /> FfR�ALARM? ❑Y�5 0 NO <br /> AS50CfATED BtlI�PING PERMIT# if a ficable)� <br /> pESCRiPTtON OF WpRK: l�Stall (9) dediCated 40 art� circuit to the n�w win t�ar in the deli area <br /> CQN�'AGT lNFQR�ATION <br /> OWNER NAM�: SateWay I I1C. T�NANT NAME if Comm�rc�al : �a�eWay #�A�B� <br /> dWNER MAILiNG AqQR�SS: s���r��2$ R�lCKef AVG' <br /> �„� Everett SrA,�WA z,P 98203 <br /> OWNER PH�NE: �WNER EMA1L� <br /> eaNTreacTo��aM�: AC Electric Service, l�nc. <br /> coNTRacraRa�pR�ss: s,���$04 W ��leeker Street Suite 102 <br /> c,n. Kent SThTE WA z�P 98032 <br /> CoNTRAC70k2 PHONE: (253� $�2-0225 cot�Tw►cTaR�M,4��: ac.elec@hotmail.cam <br /> CONTRACTO�L.IC.#(REQIliR�p): ACE�ESIOZ�J��F CITY OF EV�R�TT BUSIN�SS L.IC.#(REQUIREp)_Q542OQ' <br /> PRIMARY CONTACT: ❑OWNER �d CONTRACTQR I�OTH�R(Piease 5pacify) <br /> CQNTACT NAME: CONTACT PHC?N�: {253} 852-0�25 <br /> Katie Johnson or Kevin Lewis CONTACT EMAfL:a�,e�ec@hotmail.cam <br /> AGRE�M�NT.•1 nerony cear(y tAat I hava read ana a�rarnlnea rAls ap�frcahon ancl xnaw tAo same ro Ca ria,a anu corrocr. Ai!provrslons oflaws�na oralnances govern��g this typo <br /> ol wo�k wdr De comp�a�ed wnexno�specrfiea nere�n ar nat. ThA grenrlr�g of a permrt aaes nai presumo ro grva authonry ta�,ola�e pr cance!the pravisions of any oznei state or <br /> lacal law rvgu�Aring consrra�ctron or tha peAormance of consr�ucuon Trrat 1�m a�monzea oy rhe owner of tn�s prope�y ro perform ihe work/or wnlcn appfrcaGorr is maUo aatl I <br /> compry with trte 57aro Conr�scrorrs Law 78.27 RCW and 29B.200 I�vAC. <br /> City of Everett officral use Onry <br /> PERM IT# <br /> �� r <br /> �o /l"'I )-7 � � : � 'J — � i�,- <br /> < <br /> O erlAu tlorized Agent gnature DdRe (Revised 9/23/2016) <br />