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10rErr I ECTRICAL PERMIT At I LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1122 75TH STREET SW, Everett, WA 98203 3 1-4a <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: El COMMERCIAL <br /> USE OF BUILDING: Utility Storage <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ CO,CiC)(oU <br /> NUMBER OF DEVICES (if low voltage): 17 <br /> FIRE ALARM? I2I YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Install(j) New Fire Alarm Control Panel in the Storage Building c*kAc1 <br /> Devices in Storage Building will be added as required during this phase of the project using new wiring <br /> and backboxes. <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 /> CITY Bellevue STATE WA ZIP 98008 <br /> CONTRACTOR PHONE: 425-507-4300 CONTRACTOR EMAIL: robert.holm@siemens.com <br /> CONTRACTOR LIC.#(REQUIRED): SIEMEII91 9PP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 01 9927 <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR Cl 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 /> 2-7 (e3 E -(7 ( <br /> C <br /> Owner/Aut ri d Agent Si nature Date (Revised 9/23/2016) <br /> (17-4' <br />