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L�ECTRICAL PERMIT AP�ICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 6�O7 B2PI(SI11P@ DC'., Everett, WA 98203
<br /> BUILDING AREA(if residential, new construction, remodel, or addition) 1560 SF
<br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: � COMMERCIAL
<br /> USE OF BUILDING: ��@�@SS FaCl�lty
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<br /> CONTRACT PRICE OF WORK: $ 20,000
<br /> NUMBER OF DEVICES if low volta e : (1)APU 48VDC Generator 7.5KW
<br /> FIRE ALARM? ❑YES � NO
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
<br /> �esCR�PT�ON oF woRK: T-Mobile proposes to install (1)APU 48VDC Generator 7.5KW and (1)ASME
<br /> 120 gallon LP tank w/fill valve with integral manual shutoff valve.
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<br /> OWNER NAME: Clty Of EV@�2tt TENANT NAME(If Commercial): TOW@f Op2�8tOf- CfOW11 CBStI@
<br /> OWNER MAILING ADDRESS: srReer 2930 Wetmore Ave
<br /> cin. Everett srare WA zia 98201
<br /> OWNER PHONE: OWNER EMAIL:
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<br /> CONTRACTOR NAME: TBD � �,..d(�t. �,
<br /> CONTRACTOR ADDRESS: sTReeT
<br /> cirv STATE
<br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ,
<br /> CONTRACTOR LIC.#(REG2UIRED): �Lall( L��Q?/�^4" CITY OF EVERETT BUSINESS IC.#(REQUIRED):
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<br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR fJ]OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 206-336-3204 ��
<br /> Sarah Baird, Crown Castle, on behalf of T-Mobile coN'racr ennai�:sarah.baird@crowncastle.com
<br /> AGREEMENT.•I hereby certify fhat/have read and examined this application and know the same to be trve and correct. A!l provisions of/aws and ordinances goveming this type
<br /> of work will be completed whefher 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 regu/ating construction or the performance of construction. That/am authorized by the owner of this properiy 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 Evereft Officia!Use Only
<br /> PERMIT#
<br /> a'�^�- � 12/6/2017 � ��
<br /> � V 1./
<br /> Owner/Authorized Agent ' nature Date (Revised 9l23/2016)
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