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ELECTRICAL 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 /> IIMENINAwa ' <br /> -� <br /> °<,w��+�... . <br /> PROJECT ADDRESS: 4813 Evergreen Way, Everett WA 98203 <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: El COMMERCIAL <br /> USE OF BUILDING: Retail <br /> •• RK�, .. ...a.. .. .. , . ..e.. <br /> CONTRACT PRICE OF WORK: $ 750 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ®NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Titan Job 818287 WO 15660 Install (3) duplex receptacles for CCTV equipment. <br /> ifirooptitAvirm <br /> OWNER NAME: Wireless Vision LLC TENANT NAME(If Commercial): T- Mobile 2325 <br /> OWNER MAILING ADDRESS: STREET 4813 Evergreen Way, <br /> CITY, Everett STATE WA ZIP 98203 <br /> OWNER PHONE: 810 908 9887 (OWNER EMAIL: <br /> CONTRACTOR NAME: Titan Electric Co., Inc. <br /> CONTRACTOR ADDRESS: STREET 12828 Northup Way, Suite 205 <br /> CITY Bellevue STATE WA ZIP 98005 <br /> CONTRACTOR PHONE: 206.633.2811 CONTRACTOR EMAIL: permits@titanelectric.net <br /> CONTRACTOR LIC.#(REQUIRED): TITANEI9630B CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051191 <br /> PRIMARY CONTACT: 0 OWNER VI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206.633.2811 <br /> Linda Anderson CONTACT EMAIL: permits@titanelectric.net <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 I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> lly signed by Unda Anderson <br /> Linda A n d e rs o 'N =US,E=lindaa@btanelecMc.net,O=Titan Electric E Igt <br /> ospanyInc.,CN=LindaAndersonC <br /> :2018.11.01 08:30:51-07'00' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />