5835 HIGHWAY PL 2019-01-18 - Laserfiche WebLink

M-- ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT STIE4NFolrtilaION { yy PROJECT ADDRESS: S$3S t4_w I'1a(�i BUILDING AREA(if residential,new construction,✓ remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATOR(INFORMATION CONTRACT PRICE OF WORK:$ 1,Z3(9 NUMBER OF DEVICES(if low voltage): FIRE,ALARM? WYES D.NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Nelti _AMP5F6 CONTACT INFORMATION d ION OWNER NAME:Pacific Ridge TENANT NAME.(If Commercial): OWNER MAILING ADDRESS: STREET 21300 Victory BLVD STE 700 carr Woodland Hills STATE CA ziP 91367 OWNER PHONE: 'OWNER EMAIL« CONTRACTOR NAME: Provident Electric Inc CONTRACTOR ADDRESS: STREET PO Box 7087 ciTY Covington STATE WA ZIP 98042 CONTRACTOR PHONE:253-631-7750 X 1028 CONTRACTOR EMAIL: permits@providentelectric.net CONTRACTORLIC,#(REOUIRED): PROVIEI103C2 icrry OF EVERETT BUSINESS LIC. #(REQUIRED)t043329 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-631-7750 x 1028 Shannon Chelette CONTACT EMAIL:permits Q'providentelectric.net AGREEMENT:t 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 of work will 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# E \q-d-k 7-00 /u Owner/Authorized Agent Signature t7ate.i (Revised 9/23/2016)