9930 EVERGREEN WAY LAKESIDE MILAM RECOVERY 2019-02-06

gLECTRICAL PERMIT AftLICATION I�►� �- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 9930 Evergreen Way Everett, WA 98204 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: I COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 300 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install one internally illuminated wall sign on the tenant's south (main) exterior elevation. CONTACT INFORMATION OWNER NAME: EVERETT INVESTORS LLC TENANT NAME(If Commercial): Lakeside-Milam Recovery Center OWNER MAILING ADDRESS: STREET 15027 SE 80TH ST CITY Newcastle STATE WA ZIP 98059 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Culbertson Sign Service CONTRACTOR ADDRESS: STREET 5209 122nd St E CITY Tacoma STATE WA ZIP 98446 CONTRACTOR PHONE: 253-538-0752 CONTRACTOR EMAIL: csspermits@gmail.com CONTRACTOR LIC.#(REQUIRED): CULBESS842N6 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053695 PRIMARY CONTACT: 0 OWNER IO CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-538-0752 Hans Visser CONTACT EMAIL:csspermits@gmaii.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. C7-12/CAL CO+n►TRA One LIC&ISl✓ Cut.73ESS935'MV City of Everett Official Use Only PERMIT# �a 00y ZCl8 E e 5o to� Owner/Authorized Agent Signature 0 e (Revised 9/23/2016)