1817 BROADWAY STATE FARM INSURANCE 2022-01-18

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES ,414 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 ADDRESS: 1817 Broadway 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: New State Farm insurance office CONTRACT PRICE OF WORK: $ 2000.00 NUMBER OF DEVICES (if low voltage): 12 FIRE ALARM? 0 YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install Cat 5 network cabling with (12) outlet drop locations OWNER NAME: Chris Jones TENANT NAME(If Commercial): State Farm branch office OWNER MAILING ADDRESS: STREET 1817 Broadway CITY Everett STATE WA ZIP 98201 OWNER PHONE: 206-841-2815 OWNER EMAIL: chris.jones.ujm1@statefarm.com CONTRACTOR NAME: Wired Rite, LLC CONTRACTOR ADDRESS: STREET 12720 4th Ave W Suite F PMB #332 CITY Everett STATE WA ZIP 98204 CONTRACTOR PHONE: 206-251-4950 CONTRACTOR EMAIL: kevin@wiredritellc.net CONTRACTOR LIC.#(REQUIRED): WIREDRL96109 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 47730 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-841-2815 Chris Jones CONTACT EMAIL:chris.jones.ujm1@statefarm.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 ort cancel the provisions of any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# Kevin Marvel 04/24/2018 E t'c. I cal Owner/Authorized Agent Signature Date (Revised 9/23/2016)