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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@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PRo�ECT a,��REss: 9920 Evergreen Way <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: m COMMERCIAL <br /> USE OF BUILDING: <br /> ;' E�ECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1,000 <br /> NUMBER OF DEVICES (if low oltage): � i� <br /> FIRE ALARM? ❑YES O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF wORK: Install AES radio to monitor existing FACP <br /> CONTACT INFORMATION ' <br /> OWNER NAME: COfltf0l Z AUto R2palf TENANT NAME(If Commercial): COntf01 Z AUtO REPaIf <br /> OWNER MAILING ADDRESS: sTREET 9920 Evergreen way <br /> �,n Everett STATE WA ZiP 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: GUafdlafl S2CUflty SyStetllS <br /> CONTRACTOR ADDRESS: srREEr 1501 Kentucky St <br /> cin, Bellingham STATE WA ziP 98229 <br /> CONTRACTOR PHONE: 360-647-011 O CONTRACTOR EMAIL: SOdeII@gUafCllallS@CU�Ity.001'1'1 <br /> cotvT�,cTOR uc.#�REQuiREo�: GUARDSS233K5 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0033443 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-647-0110 eXt.327 <br /> Sheramie Odell coNTa,cr ennAi�: sodell@guardiansecurity.com <br /> 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 governing this type <br /> of work will be comp/eted whether specified herein or not. The granting of a permit does not presume to give authority to vio/ate or cance/the provisions of any other state or <br /> local law regu/ating construction or the pertormance 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 /> Digitally signed by <br /> 'Sheramie Odell PERMIT# <br /> �Date:2017.04.21 13:07:08 � <br /> � ���_—._o��oo� ��� — �g � <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) � ' �� <br /> � I � <br /> � <br />