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11111/11r.,74 EtECTRIC <br /> AL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 901 W Casino Rd Everett,Wa <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: I COMMERCIAL <br /> USE OF BUILDING: Gas Station <br /> ELECT CAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: 1730.00 <br /> NUMBER OF DEVICES(if low vol ge): <br /> FIRE ALARM? 0 YES O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install Dedicated, Isolated circuit for Commander Location,Install Dedicated,Isolated circuit for FCI Location <br /> Run conduit from existing pump communication interface box to FCI location. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): Arco <br /> OWNER MAILING ADDRESS: siREET 901 Casino Rd <br /> cm. Everett STATE Wa ZIP 98203 <br /> OWNER PHONE: 425-347-6599 OWNER EMAIL: <br /> CONTRACTOR NAME: Sme Solutions <br /> CONTRACTOR ADDRESS: STREET 10107 South Tacoma Way <br /> cny Lakewood STATE Wa ZIP <br /> CONTRACTOR PHONE: 253-606-0393 CONTRACTOR EMAIL: Mark@smesolutions.com <br /> CONTRACTOR LIC.#(REQUIRED): Smesosl93k1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED. 045511 <br /> PRIMARY CONTACT: 0 OWNER lZ CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-606-0393 <br /> Mark CONTACT EMAIL:Mark@smesolutions.com <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 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 <br /> local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 6-/-/ 7 E \gn(o -- w10 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />