5001 EVERGREEN WAY 2019-03-21 - Laserfiche WebLink

kECTRICAL PERMIT APPLICATOI ,,.. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425.257-8810 I FAX 425-257-8857 (E)eve€etteps©everettwa ev I vmiwv.everettwa.govlperrrrits PROJECT SITE INFORMATION PROJECT ADDRESS:5001 Evergreen Way, Everett, WA 98201 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: C3SFR-DETACHED 0 SFR-ATTACHED CI DUPLEX 1:7 MULTI-FAMILY-#OF UNITS: RI COMMERCIAL USE OF BUILDING: Fuel Station ELECTRICAL APPUCATIC!NINFORMATION CONTRACT PRICE OF WORK:$ 4000.00 NUMBER OF DEVICES Qf low voltage): FIRE.ALARM? CI YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable):. DESCRIPTION OF WORK: Replace existing fuel dispensers with new fuel dispensers,extend wiringas needed. CONTACT INFORMATION OWNER NAME:Jackson Food Stores TENANT NAME(if Commercial):Everett Shell OWNER MAILING ADDRESS: srtsr:T 5001 Evergreen Way env Everett STATE WA 21p 98201 OWNER PHONE: 208-699-5511 OWNER EMAIL les2003J@grnail.corn CONTRACTOR NAME: Independent Electrical Services, LLC CONTRACTOR ADDRESS sTReeT209 N Frederick St. city Post Falls WATS IUzip 83854 CONTRACTOR PHONE:208-699-5511 CONTRACTOR EMAIL: ieS 003ji grriell.cprn CONTRACTOR LIG.#REQUIRED): INDEPES947C8 CITY OF EVERETT BUSINESS LIC,CREOUIREDy se receipt PRIMARY CONTACT. DOWNER is CONTRACTOR D OTHER(Please Specify) 491 b ?11 CONTACT NAME;, CONTACT PHONE: 208-699-5511 Jason Shoemaker CONTACT EMAIL:ies20O3j grnail.corrl AGREEMENT:t hereby certify that f:have read and examined this application end know the seine to be true and correct. All provisions or laws and ordinances governing this type of work will be completed whether specified herein ar'net The granting of a permit does',not presume to give authotity-to violate or cancel the provisions of any other state or local law regulating construction or the Wince of construction. That lam authorized by the owner of this property to perforin the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296,200 WAC. Chir of Emelt Official Use Only PERMIT# EI $C& l riAuthorized Agent Signature fr/ir (Revised 9/23/2016)