15 SW EVERETT MALL WAY MOLINA HEALTH CARE 2019-02-05

Egrr LECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 l FAX 425-257-8857 l (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 15 SW Everett Mall Way, #A BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: © COMMERCIAL USE OF BUILDING: Medical/Retail ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 8,000 NUMBER OF DEVICES (if low voltage): 2 FIRE ALARM? 0 YES El NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Installation of(2) internally lit wall signs. LED internal illumination CONTACT INFORMATION OWNER NAME:JLL TENANT NAME(If Commercial): Molina Health Care OWNER MAILING ADDRESS: STREET 1402 SE Everett Mall Way c,TY Everett STATE WA ZIP 98208 OWNER PHONE: 425355-1771 OWNER EMAIL:Glen.Bachman@am.jll.Com CONTRACTOR NAME: Northwest Sign & Design CONTRACTOR ADDRESS: STREET 17201 Beaton Rd SE CITY Monroe STATE WA ZIP 98272 CONTRACTOR PHONE: 425-844-6415 CONTRACTOR EMAIL: jeff@nwsigns.com CONTRACTOR LIC.#(REQUIRED): NWSIGS*84201 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):053987 PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4.255-844-6415 Jeff Carl CONTACT EMAIL:jeff@nwsignS.com 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 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 I am 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. n City of Everett Official Use Only PERMIT# � �� E [ i-f Owner/Aut • T'= Si.ature Date (Revised 9/23/2016)