5845 HIGHWAY PL 2019-03-18 - Laserfiche WebLink

I ELECTRICAL PERMIT APPLICATION - CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits .. a PROJECT SITE INFORMATION PROJECT ADDRESS: 4::iotl S- 1-1i9liwa Platt p� BUILDING AREA(if residential,new construction remodel,or addition) 1 5$7. SF BUILDING TYPE: 0 SFR-DETACHED el SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION . - CONTRACT PRICE OF WORK:$ ` 9 NUMBER OF DEVICES (if low voltage): FIRE ALARM? gI YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: N4w 100 .AP 3 F C CONTACT INFORMATION OWNER NAME:Pacific Ridge TENANT NAMEtlf Commercial): OWNER MAILING ADDRESS: STREET 21300 Victory BLVD STE 700 c,n Woodland Hills STATE CA ZIP 91367 OWNER PHONE: OWNER EMAIL: • CONTRACTOR NAME: Provident Electric Inc CONTRACTOR ADDRESS: STREET PO Box 7087 c,TM Covington STATE WA zip 98042 CONTRACTOR PHONE:2'553-631-7750 X 1028 "CONTRACTOR EMAIL: permits@providentelectric.net CONTRACTOR LIC.#�toui.ftEb): PROVIEI1 O3C2 .tw#Ty OF EVERETT BUSINESS LIC.#(REQUIRED):043329 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑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 stat or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to pe t e tk tir nh applicati s de n comply with the State Contractors Law 18.27 RCW and 296.200 WAC. �+ City of Everett Official Use Only PERMIT# q/Z.-7/1-7 JE14 - 95 . _ 4 Owner/Authorized Agent Signature Date (Revised 9/23/2016)