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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 I (E)everetteps@everettwa.gov I www.everettwagovipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS; 3620 Broadway <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Verizon Store <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 150.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): S1802-007 <br /> DESCRIPTION OF WORK: Make electrical connection to new sign <br /> CONTACT INFORMATION <br /> OWNER NAME:Van Winkle Properties TENANT NAME(If Commercial):Verizon <br /> OWNER MAILING ADDRESS: STREET 2410 38th St <br /> CITY Everett <br /> STATE WA ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Sign-Tech Electric <br /> CONTRACTOR ADDRESS: STREE,5009 Pacific Hwy E, Suite 11 <br /> Fife <br /> STATE WA ZIP 98424 <br /> CONTRACTOR PHONE: 253-922-2146 CONTRACTOR EMAIL: Jessica©signtechelectric.com <br /> CONTRACTOR LIC.#(REQUiRED): SIGNTEL988BG CITY OF EVERETT BUSINESS LIC.etiREouiRED):034625 <br /> PRIMARY CONTACT: 0 OWNER 2 CONTRACTOR 0 OTHER(Please Specify) <br /> 'CONTACT NAME: CONTACT PHONE: 253-922-2146 <br /> Ken or Jessica CONTACT EMAIL:jessica@signtechelectric.corn <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 wilt be completed whether 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 regulating construction or the performance 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-16.27 ROW and 296.200 WAC, <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E . 663- il? <br /> t,„LAia)at,L,, <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />