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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PRo�ECT a��REss: 410 SW Everett Mall Way <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: m COMMERCIAL <br /> USE OF BUILDING: St0►'@ %��/��L �}LY�j�'��% j/-`. <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 372.00 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES m NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: Alter an existing branch circuit by extending to create an exterior receptacle with a <br /> weather proof cover. This receptacle will provide power to an retractable awning <br /> CONTACT INFORMATION <br /> OWNER NAME: M2tt EppS TENANT NAME(If Commercial): C8f TOyS <br /> OWNER MAILING ADDRESS: s1REET 410 SW Everett Mall Way <br /> c,n Everett STATE WA Z,P 98203 <br /> owNER PHONE: 425-239-6549 OWNER EMAIL: MEppS p�CBflOyS.COR1 <br /> coNTRacTOR NannE: Rainier Industries <br /> CONTRACTOR ADDRESS: srReeT 18375 Olympie Ave S <br /> �,T,, Tukwila STATE WA Z,P 98188 <br /> CONTRACTOR PHONE: 206-701-1925 CONTRACTOR EMAIL: brade@ralCll@f.00171 <br /> coNTw�cTOR uc.#�REQuiRE��: RAINIIL948QF CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 023736 <br /> PRIMARY CONTACT: ❑OWNER m CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2Q6-7O1-"I JZ5 <br /> Brad Ehlers - Electrical Admin coNTacT Ennai�: brade@rainier.com <br /> AGREEMENT:1 hereby certify that I have read and examined this application and know the same to be t�ue and correct. AlI provisions of laws and ordinances governing this type <br /> of work will be comp/eted whethe�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 1 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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ��,� �� ��,U ��li�l zn�� f E I'I I I - I ��1 <br /> OwnerlAuthori ed Agent Signature Date (Revised 9/23/2016J <br />