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471677 ELECTRICAL PERMIT AI LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1122 75TH STREET SW, Everett, WA 98203 DF F ( C 5' <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 3100 SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: I COMMERCIAL <br /> USE OF BUILDING: Utility Storage <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2_, Oco <br /> Ow <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Install (t i New Fire Alarm Control Panel 'I c t' <br /> ____. Field devices in Office Building will be upgraded at later phase. j t p <br /> 1,/.3i1� .o � � -��� V S\,._en Qv, c 7( (S k/\€ <br /> v\e ( <br /> CONTACT INFORMATION <br /> OWNER NAME: 75th Street Business Center TENANT NAME(If Commercial): Snohomish Co. Public Utility District <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Siemens Industries <br /> CONTRACTOR ADDRESS: STREET 15900 SE Eastgate Way, Suite 200 <br /> CIN Bellevue STATE WA ZIP 98008 <br /> CONTRACTOR PHONE: 425-507-4300 CONTRACTOR EMAIL: robert.holm@siemens.com <br /> CONTRACTOR LIC.#(REQUIRED): SIEMEI I91 9PP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019927 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425) 241-7407 <br /> Robert Holm CONTACT EMAIL: robert.holm@siemens.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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 09.72-7/78 E G/ - l70 <br /> Owner/Aut n d Agent Si nature Date (Revised 9/23/2016) <br /> !/Z <br />