2722 COLBY AVE RAINIER TITLE 2019-03-25

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 l www.everettwa.gov/permits PROJECT SI't E'INFORMATiON PROJECT ADDRESS:2722 Colby Ave Suite 100 BUILDING AREA(if residential,new construction,remodel,or addition)6328 SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Commercial Multiple Tenants ELECTRICAL APPLiCATIONj iiiiPORMATION CONTRACT PRICE OF WORK:$ 13,187.83 NUMBER OF DEVICES(if low voltage):45 FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install new or relocate existing Data Cabling • CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial):Rainier Title OWNER MAILING ADDRESS: STREET 2722 Colby Ave Suite 100 cin.Everett STATE WA ZIP 98201 OWNER PHONE: 425 252 1222 OWNER EMAIL: CONTRACTOR NAME:TelData Systems Inc CONTRACTOR ADDRESS: STREET 1158 Industry Drive CITY Tukwila STATE WA zip 98188 CONTRACTOR PHONE:206 682 8721 CONTRACTOR EMAIL: srahier@teldatainc.com CONTRACTOR LIC.#(REQUIRED): TELDASI955PB CITY OF EVERETT BUSINESS LIC.#(REQUIRED):027126 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 682 8721 Steve Rahier CONTACT EMAIL:srahier@teldatainc.com AGREEMENT:I hereby certify that 1 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 t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only ; 114) PERMIT# .. "i -- 6/27/1 8 E I(6d (i' 1 9)(e Owner/Authorized Agent Signature Date (Revised 9/23/2016)