5837 HIGHWAY PL 2019-01-18 - Laserfiche WebLink

ELECTRICAL PEEZmIT 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 I www.everettwa.gov/permits PROJEtt Silt INFO ION PROJECT ADDRESS . ,, t. BUILDING AREA(If residential,new cottstru ;=n,remodel,or addition) i Sl $F BUILDING TYPE: 0 SFR-DETACHED fa SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: mm 0 COMMERCIAL USE OF BUILDING: TRI S-°APPLt AT1ON INFORMATION '' CON'T"RAOT PRICE OF WORK:$1 r NUMBER OF DEVICES(If low voltage): FIRE ALARM? IBES 0 NO ASSOCIATED BUILDING PERMIT#(ifapplicable): DESCRIPTION:OF WORK: 100 Aitir' SPA t �t 0 00 CONTACT INFORMATION OWNER NAME:Pacific Ridge TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 21300 Victory BLVD STE 700 ctTv Woodland Hills STATE CA ZIP 91367 OWNER PHONE: DOWNER EMAIL: CONTRACTOR NAME: Provident Electric Inc CONTRACTOR ADDRESS: STREET PO Box 7087 CITY Covington STATE WA ZIP 98042 CONTRACTOR PHONE:253-631-77550 X 1028 CONTRACTOR EMAIL: permitS@prOVidentelectric.net CONTRACTOR LIC.#(RECt If2ED): PROVI El 103C2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED 043329 PRIMARY CONTACT: 0 OWNER fa CONTRACTOR 0 OTHER(Please Specify). CONTACT NAME: CONTACT PHONE: 253-631-7750 x 1028 Shannon Chelette CONTACT EMAIL:permits@providentelectric.net AGREEMENT:I hereby certify that t 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 lam 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# 4,0),...1,0‘...„... CIPZ,Iii 1 E %4 -cA9 Owner/Authorized Agent Signature Date (Revised 9/2372016)