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�! I I <br /> t <br /> s <br /> � :: ELLCT�t�Ci�L� �E���T APf�L�C�►T`IO� <br /> � _ _ _ <br /> � <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 /> � <br /> : _ _ _. __ _. _ __ __ _. <br /> _ __ _ _ __ __ _ __ _ _ _ <br /> . _ _ � _ _ - <br /> _ ` PRQ.IECT StTE 1�F�R�iM1'�'10� ; ' <br /> „ _ <br /> : eRo�ecr aooRess: 15 SW EVERETT MALL WAY SPACE G-H <br /> ', �UILDING AREA(if residential,new cons#ruction,remodef,or addition) SF <br /> BUILDING TYPE. ❑ SFR DE..T.ACHED 0 S..F..R-ATTACHED ❑pUPLEX_ ❑MULTI-FAMI.LY-#OF UNITS: 0 GOMMERCIAL <br /> _ _....... <br /> _, _,.. <br /> USE OFBUILDING: MIXED USE <br /> . _...._.._ _ __ _... <br /> ___. _ _ ._ _ _ <br /> ELE�TR�CA�A�PL�C;��"�O���ORIi�AT�4N <br /> _ _ <br /> 'CONTRACT PRICE OF WORK:$ 400 <br /> NUMBER OF DEVICES .if low volta e; 3 LOW VOLTAGE THERMOSTATS <br /> : FIRE ALARM? ❑YES 0_NO __ _ __ _ <br /> _ _ _ _ <br /> ',ASSOCIATED BUILDING PERMIT# if a licable;�: <br /> __ ........ _ <br /> : <br /> DESCRIPTION OF WORK. INSTALLATION OF 3 LOW VOL7AGE THERMOSTATS AND ASSOCIATED WIRING <br /> � � __ .._ ._. , _._ . <br /> CO�iTACT NNFQi�A'T�Q�1 -: <br /> _ _ . <br /> OWNER NAME: ROSEN BEL-KIRK ASSOCIATES LLC TENANT NAME If Commercial; VIDA INTEGRATED HEAL7H <br /> _ _.. __ <br /> OWNER MAILING ADDRESS: sTReeT p0 BOX 5003 <br /> cm, BELLEVUE srn� WA zia 98009 <br /> fJ!fi{tt�'E PHON..E. QW. NER EMAIL: <br /> �ONTRACTOR NAME: EMERALD AIRE, INC. <br /> _ , __ <br /> CONTRACTOR A�DRE.SS: _ srReeT 5108 D ST NW <br /> � ��T, AUBURN � STATE WA Z1P 98001 <br /> ...__ ..... .____ <br /> CONTRACTOR PHONE: 253-872-5665 CONTRACTOR EMAIL: PERMITSQa EMERALDAIRE.COM <br /> �#3�ITFC�1�7'C�:LIC.��QIlIR�Lk;: EMERAA1055BL �pF EVERETT BUSiNESS LIC.�F�q1U1R�C�}.022819 <br /> ' PRIMARY CONTACT: �OWNER 0 CONTRACTOR ❑oTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-872-5665 <br /> MIRANDA MENDEZ coNTacr EMni�: PERMITS@EMERALDAIRE.COM <br /> AGREEMENT:f hereby certify that t have read and examined this app/ication and know the same to be true and correct. All provrsions of laws and ordinances goveming this type <br /> of work wi(1 be completed whether speci�ed herein or nof. The grenting of a permit does not presume to gtve authority to violate oi cance/the provlsions of any other state or <br /> local law regutafing cortsfruction or the pertormance of construction. That/am authorized by the owner of this properfy te perform the work for whfch application is mede and( <br /> compty with the State Contractors Law 18.27 RC W and 296.200 WAC,- <br /> Clty of Everett O/(iciaf(Jse Onty <br /> 'PERMIT# <br /> : D � <br /> E � (� l n `� 'r� <br /> �Spr��Rig,�pp�c�/►gent Signature - " at�: (Revised 9/23/2016) <br />