5 W CASINO RD 2019-03-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION /111POOV -. 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: 5 West Casino Road 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: 0 COMMERCIAL USE OF BUILDING: Day Care ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 725.00 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install one outlet at front desk CONTACT INFORMATION OWNER NAME:Kindercare KUN-301 146 TENANT NAME(If Commercial):Same OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Northwest Edison CONTRACTOR ADDRESS: STREET 11807 N Creek Parkway S Suite B-103 CITY Bothell STATE WA ZIP 98011 CONTRACTOR PHONE:425-273-7171 CONTRACTOR EMAIL: joanb@nwedison.com CONTRACTOR LIC.#(REQUIRED): NORTHEI983RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED):050699 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-273-7171 Adam Sangder CONTACT EMAIL:joanb@nwedison.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. City of Everett Official Use Only PERMIT# g.--tr-zoe E g 06,2 - Owner/Authorized Agent Signature Date (Revised 9/23/2016)