Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> '&/�►' - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1330 SE Everett Mall Way <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Commercial <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2050.00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES El NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Disconnects and reconnect in new configuration after fixture and gondola <br /> moves; utlizing existing circuits. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): Best Buy 566 <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Lin R Rogers Electrical Contractors Inc <br /> CONTRACTOR ADDRESS: sTREET2050 Marconi Drive Suite 200 <br /> cn Alpharetta STATE GA ZIP 30005 <br /> CONTRACTOR PHONE:770-772-3400 CONTRACTOR EMAIL: License@LRogersElectric.com <br /> CONTRACTOR UC.#(REQUIRED): EC LINRRR956B1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):051310 <br /> PRIMARY CONTACT: 0 OWNER la CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 770-772-3491 <br /> Jacquelyn Groethe CONTACT EMAIL:License©LRogersElectric.com <br /> AGREEMENT:1 hereby certify that!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 lam 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 /> Ck-' L-- PERMIT# <br /> E 1 BO2i 22°1 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />