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�E�TRICAL PERMIT �LICATION <br /> C1TY 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/peRnits <br /> ` PROJECT SITE INFORMATION ; <br /> PRo�ec-raooRess: 1130 SE Everett Mall Wa <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: O SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Retail <br /> " ` ELECTRICAL APPLICATION INFORMATION , . ,' <br /> CONTRACT PRICE OF WORK:S 850.00 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : N/A <br /> DESCRIPTION OF WORK: Disconnecting the electrical to the current gondola/display, they will be putting a <br /> new amazon tablet table in its place, once this is set up we will retum to reconnect the electrical work. <br /> '- ' CONTACT INFORMATION . : <br /> OWNER NAME:B@St BU TENANT NAME If Commercial):B@St BU�/ <br /> OWNER MAILING ADDRESS: S�E� 1130 SE Everett Mall Way <br /> �,� Everett �,,�WA Z�98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Lin R. Rogers Electrical Contractors, Inc. <br /> CONTRACTORADDRESS: S,�E�2050 Marconi Drive, Ste 200 <br /> �,,;,Alpharetta �A� GA Z� 30005 <br /> CONTRACTOR PHONE: 770-772-7921 CONTRACTOR EMAIL: license@Irogerselectric.com <br /> CONTRACTOR LIC.#(REQUIRED): ECLINRRRR956B1 CITY OF EVERETT BUSINESS LIC.#(REQUI D)� O <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 770-772-7J2'( <br /> shley Walls CONTACT EMAIL:�i�nse@Irogerselectric.com <br /> AGREEMENT.-1 hereby certify that I have read and examined this applicafion and know tire same to be true and correct Alt provisions oflaws and ordinances govemirtg this lype <br /> of wwk wiN be c�r►pleted whether specified herein or not. The grartting of a pe�mit does not presume to give auttrori(y to violate or cancel tlre provisions of any other state� <br /> locat(aw regulating construction or the performance oi const►uction. Ti►at f am aufhorized by Ure owner of this property to periorm the wodc for which application is made artd/ <br /> comply witlr the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Eve►ett Official Use Only <br /> PERMIT# <br /> � <br /> E �t�( � -- 0�, C <br /> OviinedAuthaized Agent Sig re Date (Revised 9%23/2016) <br />