11400 EVERGREEN WAY 2019-02-06 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION - - 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 1y�' p,/� y� PROJECT ADORES- ' 99 - - 1 A - ` - , ►1 ' •82043- i\4110 S+ n-C'eA L VW W BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: Wal-Mart-Shopping Center ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 85,000 NUMBER OF DEVICES(if low voltage): 25 EPVM Monitors-17-Cameras FIRE ALARM? 0 YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: installation of 25 EPVM Monitors- 17-Cameras 00 CONTACT INFORMATION OWNER NAME:WAL-MART STORES INC TENANT NAME(If Commercial): Walmart OWNER MAILING ADDRESS: STREET PO BOX 8050 ern, BENTONVILLE STATE AR 21P 72712 OWNER PHONE: (OWNER EMAIL: CONTRACTOR NAME: WaCitli'er, Inc.. CONTRACTOR ADDRESS: srnEET 16001 West 99th Street cry Lenexa STATE KS ZIP 66219 CONTRACTOR PHONE: 913.227.3911 CONTRACTOR EMAIL: permitrequest©wachter.com CONTRACTOR LIC.#(REQUIRED): EC WACHTI*904KL ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 043582 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 913.227.3911 Samantha Thomas CONTACT EMAIL:Samantha.Thomas@wachter.com AGREEMENT:t hereby certify that I have read and examined this application and know the same to be true and correct. AN 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 l 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 298.200 WAC. City of Everett Official Use Only PERMIT# s: ► S E OwnerlAutho Signature Date (Revised 9/23/2016)