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477- ICTRICAL PERMIT AP&ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 1. ,'E r. . , �p . $_ : PT OJECT SITE IINFOI MA'I'1�ON E a. <br /> Y £ <br /> - � _e-_- ..w.v a.r,, r. .-.9v� � � �._w�......e v. ,r✓Pu;. .., sem' e..��� � AMsp NOI <br /> PROJECT ADDRESS: 221 SE Everett Mall Way, Suite M-2 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: I COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATIO�1 IIIFO.RMATION' <br /> CONTRACT PRICE OF WORK: $ 360.00 <br /> NUMBER OF DEVICES (if low voltage): 2 <br /> FIRE ALARM? 0 YES 0 NO �21 qpp�� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): B1808-005 -� 1 ,, <br /> (ZjbU- ()IL <br /> DESCRIPTION OF WORK: Installation of one (1) thermostat and one (1) temperature sensor. <br /> CONTACT INFORMATION <br /> OWNER NAME: Shilla Incorporated TENANT NAME(If Commercial): Red Wing Shoes <br /> OWNER MAILING ADDRESS: STREET 221 SE Everett Mall Way <br /> c,n Everett STATE WA ZIP 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Evergreen Refrigeration <br /> CONTRACTOR ADDRESS: STREET 727 South Kenyon St. <br /> ciTr Seattle STATE WA Z,P 98108 <br /> CONTRACTOR PHONE: 206-763-1744 CONTRACTOR EMAIL: aleXb@evergreenhvac.com <br /> CONTRACTOR LIC.#(REQUIRED): EVERGRL954R2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044350 <br /> PRIMARY CONTACT: 0 OWNER Q1 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-763-1744 <br /> Alex Burkhart CONTACT EMAIL: alexb@evergreenhvac.com <br /> 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> it/11 it'd EItblo�d�� <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />