7621 EVERGREEN WAY PLANET FITNESS 2018-05-15

E��CTRICAL PERMIT APF��CATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PRo�ecT ao�REss: 7621 Evergreen Way BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 100.00 NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: InSt811 2 W811 SIgnS CONTACT INFORMATION OWNER NAME: Planet FltneSS TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTaEer 7621 Evergreen Way �„,, Everett g7q7E WA Z,P 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: B@fl�/ Slgll Sy5t2f11S CONTRACTOR ADDRESS: sTrxeer 7400 Hardeson Rd c„-,, Everett STATE WA ZiP 98203 CONTRACTOR PHONE: 425.776.8835 CONTRACTOR EMAIL: traCIES p�bel'1')/S191lSySt@171S.COCT'1 CONTRACTOR LIC.#(REQUIRED): berrySSH�J3W7 CITY OF EVERETT BUSINESS LIC.#(REGIUIRED): 24786 PRIMARY CONTACT: ❑OWNER Ql CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.776.8835 X 1 14 Tracie Skiles coNTacr eMai�:tracies@berrysignsystems.com 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 goveming this type of work will be completed whethe�specified herein or not. The granting of a permit does not presume to grve authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett O�cial Use Only PERMIT# �a , � E 0 , �Z.=- �'i '�'� Owner/A h e gent Signature Date (Revised 9/23/2016)