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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE5 <br /> 3200 CEDAR STREE7, EVERETT,WA 98201 <br /> {P)425-257-88t0 ( FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.evereftwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECTADDRESS: 6414 Hardeson Rd FedEx Frei ht Inc <br /> BUILDIN(3 AREA(if residential,new construction,remodel,or addition) SF <br /> BUfLDfNG TYPE: ❑SFi2-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UN1TS: 0 COMMERCIAL <br /> USE OF BUILDING: (�i011lfll@I'Cld� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRlCE OF WORK:a 1500.00 <br /> NUMBER OF DEVICES if low valta e : <br /> FIRE ALARM? ❑YES �NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTlON�F WORK: We wili install(2) - 20A dedicated circuits for the existing UPS back up system. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME If Commercial:FedEX Ffei flt ��C <br /> OWNER MAILING ADDRESS: STREET <br /> � C11Y STATE ZIP � <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Litl R RO ers Electrical Contractors inc <br /> coNrRncTOR�woRess: s�EET2050 Marconi Drive Suite 100 <br /> �,�Alpharetta ST,,,�GA ziP 30005 <br /> CONTRACTOR PHONE:77�-772-3400 coNT�►cTOR eMa�: License@LRogersEfectric.COtYI <br /> coNrw►cTOR uc.#�ReQuiRe��: EC LtNRRRR956B1 CITY OF EVERETT BUSINESS LIC.#REQUIRED):a5�3�I O <br /> PR[MARY CONTACT: ❑dWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 774-772-3491 <br /> Jacquelyn Groethe coNracr en�a�:�icense@�Ro ersElectric.com <br /> AGREEMENT:1 hereby certify thet 1 have read and examined this app�ice8on and know the same fo be true and correct. All provlsions of laws and oMinances goveming fhis type <br /> af work wil/be completed whether specihed herein or not The granting of a permit does nat presume to g'rve authority to vio/ate or cancel the provisions of any othe�state or <br /> loca!law iegu/ating consfrucNon ar ihe performance of conshuation. That i am authorized by the owner of this properly to perfam the work for which apptication is made and t <br /> comp►y with the Stata Contractors Law 18.27 RC W and 296.200 WAC. <br /> City of Everett O�cial Use Only <br /> PERMIT# <br /> E 1�0�' O�1Z <br /> Owner/Authorized geM Signature Date (Revised 9/23/2018) <br />