1715 BROADWAY 2018-01-05 - Laserfiche WebLink

� � ELECTRICAL PERMIT APPLICATI�N C17Y OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 982Q1 (P)425-257-8810 � FAX 425-257-8857 � (E}everetteps@everettwa.gov � www.everettwa.gov/perrnits PR�JECT SITE IN�ORMATION �Ro�ecr a,�o�ss: Safewa #474 - 1715 Broadwa Everett, WA 98201 BUILDINO AREA(if residential,new construction,remodel,or addition)d$II al'@a SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED �DUPLEX ❑ MUI.TI-FAMILY-#OF UNITS: �I COMMERCIAL USE 8F BUILDING: ' LEC ICAL APPLICATiON INFORMATION CONTRACT PRICE OF WORK: 1500 � NUMBER OP DEVICES if low v Ita e : % FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMI if a licable : DESCRIPTION OF WORK: Install a dedicated 40 Am circuit to the new win bar in the deli area CONTACT INFORMATION OWNER NAME:Saf@Wa TENANT NAME If Commercial : OWNER MAILING ADDRESS: sraeer 1715 Broadway �,ri Everett gTA7E WA Z�P 98201 OWNER PHONE: OWNER EW4AIL: CONTRACTOR NAME:AC Electric Service, Inc. CONTRACTOR ADDRESS: STAEET804 W Meeker St Ste102 �,�Kent STA-�WA Z�P 980�'"�� CONTRACTOR PHONE:2�J3-852-OZ25 CONTRACTOR EMAIL: aC.@I@C Q�IIOtI'Y'lall.com � CONTRACTBR LIC.#(REQUIRED): ACELESIOZ�JDF ClTY OF EVERETT BUSINESS LIC.#(REQUI D):��2�4 PRIMARY CONTACT: ❑OWNER fid CONTRACTOR ❑OTHER(Please Specify) ;'� CONTACT NAME: CONTACT PHONE: 2rj�-$rj2-022rj Katie Johnson or Kevin Lewis CONTACT EMAIL:ac.eiec hotmail.com '� AGREPMFNT:!here6y ceRify that!have read and examined flvs applrcaffon and know the same to be trua and correcf. ANprovisions o(lews arxi ordlnances goveming this rype o/wo�fc witl be canpleted whether specfied herein or not. Tire grenting o(a pertnk does not presume fo grve suthorrry to violate or cancel the provisions of eny other state or local law regulefing construcGon o�lhB performance of consfrt�cSon. That!am authorized by the ownar of this proparty to perfomt the worfc for which applicafbn u made snd 1 comply with the State Contrscfors Law 18.27 RCW and 296.200 WRC. City of Everett Othcia!Use Only PERMIT# a�� ti-� E ��-�g -Dcl� nerlAuthor! d ent Slgnature Date (Revised 3/23/2018}