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&CTRICAL PERMIT APIMCATION <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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:3003 West Casino Road, Building 45-12 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) TI SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $4,577 <br /> NUMBER OF DEVICES (if low voltage): 16 <br /> FIRE ALARM? ❑YES ONO <br /> ASSOCIATED BUILDING PERMIT#(if applicable):N/A <br /> DESCRIPTION OF WORK: Install and terminate (2)Access Control Panels, (2) Power Supplies, access controls for <br /> (2) doors, and (2) cameras. Titan Job#166023 <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): Boeing Company <br /> OWNER MAILING ADDRESS: STREET <br /> CIT`( STA TE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Titan Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET 12828 Northup Way Ste. 205 <br /> (-,,Ty Bellevue STATE WA ZIP 98005 <br /> CONTRACTOR PHONE:206-633-2811 CONTRACTOR EMAIL: info@titanelectric.net <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: Laurissa Carroll CONTACT PHONE:206-735-9498 <br /> CONTACT EMAIL:laurissac@titanelectric.net <br /> AGREEMENT.' T 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 <br /> 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 <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 /> FEE <br /> - PERMIT# <br /> 2/22/16 E <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />