6301 36TH AVE W BYRAM HEALTHCARE 2018-04-16

ELECTRICAL PERMIT APMLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECTGSITE INFORMATION PROJECT ADDRESS: 104701 3(r 11,1e. W cut c too BUILDING AREA(if residential,new construction,remodel,or addition) 24.01 S SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: b ;C 10.111„0.LVt ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1,Z50.°- NUMBER OF DEVICES(if low voltage): (3' FIRE ALARM? ❑YES le NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Run low voltage wire, install ( 3 )t-stat(s), zone stat(s)or control device(s) M 11Io--D(D CONTACT INFORMATION OWNER NAME:} y ,, 4(` ilk St. U(, . TENANT NAME(If Commercial): 1,tir,Nwt 1EA[k1nl..A.R.E.:1-.% . OWNER MAILING ADDRESS: STREET (,%41b csal-�sraV (,SQU) !SO ^ CITY c Att4tS STATE 1,\A.0. ZIP 1%353, OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Universal Refrigeration CONTRACTOR ADDRESS: STREET 4102 B PL NW CITY Auburn STATE WA ZIP 98001 CONTRACTOR PHONE: 253-939-5501 CONTRACTOR EMAIL:1% A @universalrefrig.com CONTRACTOR LIC.#(REQUIRED): UNIVERI 000130 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 027645 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-939-5501 A‘1 4-‘r% CONTACT EMAIL:6011A @universalrefrig.com 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 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 PERMIT# q / z9 I r-/ E 1'11 -- 7 (i0� Owner er Authorize Agent Signature Date (Revised 9/23/2016)