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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@everetfinra.gov� www.everettwa.gov/permits <br /> �� ��\,.: ����ry F � \\g _� ... �s� � a�� . <br /> �-u � �,���.����� � .,.,�p. ��"�i�` ;a.�"�.t'.< ,�:.:����\� <br /> PROJECT ADDRESS:3003 West Casino Road[Boeing 40-09] <br /> BUILDING AREA(if residential, new construction, remodel,or addition)_ addition SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL <br /> USE OF BUILDING:COt111112CC18� <br /> � z � ,�� � �`� �'•: ��r�����"� <br /> . <br /> �� r e�. �� � s. , � ����\� �.��a <br /> ., �.w. .... ........ �....... �.: ., <br /> ��� <br /> CONTRACT PRICE OF WOR $1,199 <br /> NUMBER OF DEVICES if low Ita <br /> FIRE ALARM? ❑YES ✓ N <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: Install(1)Access Control Panel and(1)Po y.Install and terminate(1)Card Reader,(1)Door <br /> Contact,and(1)REX.Terminate(1)Gate Strike and Terminate Panel. it job 176108 <br /> ���,�� .. "�N�;�`'' ;,1,� ��M�T'� � ,.,,; <br /> f � ,v,��3 is.� !�,;� ��� � � <br /> OWNER NAME: BOelri TENANT NAME If Commercial): BOeiri <br /> OWNER MAILING ADDRESS: sTReer 3003 W Casino Road <br /> crrr Everett STATE wA ZiP 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Titan Electric, Inc. <br /> CONTRACTOR ADDRESS: sTReer 12828 Nol�hup Way Ste. 205 <br /> �ir. BellevU2 STATE WA ziP 98005 <br /> CONTRACTOR PHONE:206-633-2811 CONTRACTOR EMAIL:info@titanelectric.net <br /> CONTRACTOR LIC.#(REQuiRE�):EC TITANEI9630B CITY OF EVERETT BUSINESS LIC.#(REQUIRED): OS 1191 <br /> ow.�� . .. �. ,. <br /> ,. ..,,... U. .�.. ��. ..............y� <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTAC7 NAME: Elaia Wainright CONTACT PHONE:206-633-2811 <br /> CONTACT EMAIL:elaiaw@titanelectric.net <br /> AGREEMENT.�T hereby certify that 1 have read and examined this application and know the same to be true and correct All provisions of laws and ordinances goveming this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority fo violate or cancel the provisions of any other state or <br /> local law regulating construction or the pertormance of construction. That I am authorized by the owner of this property to perform the work for which applicafion is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Oniy <br /> FEE <br /> � � • 1 � <br /> �r i� PERMIT# <br /> N'' S�12��� E ��S -- o�� <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />