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4ren" ELECTRICAL PERMIT APPLICATION
<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
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<br /> PROJECT SITE INFORMATION
<br /> PROJECT ADDRESS: 1 1 400 •b 19'tN' `99'9^" 5\10111~
<br /> BUILDING AREA(if residential,new construction,remodel,or addition)91000 SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING: Retail
<br /> ,ELECTRICA}} APPLICATION I ` O
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<br /> CONTRACT PRICE OF WORK: $ 2600000
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? 0 YES El NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: Retroft of interior lighting fixtures from Fluorescent to new LED lamps and drivers, and some
<br /> LED kits
<br /> CONTACT INFORMATION'
<br /> OWNER NAME:Wal-Mart TENANT NAME(If Commercial):Wal-Mart 5195
<br /> OWNER MAILING ADDRESS: STREET 702 SW Eighth Street /�
<br /> c,n Bentonville STATE AR Z,p 72716
<br /> OWNER PHONE: 479-273-4000 OWNER EMAIL:
<br /> CONTRACTOR NAME: Northwest Edison
<br /> CONTRACTOR ADDRESS: STREET 11807 North Creek Parkway S Sutie B-103
<br /> CITY Bothell STATE WA zip 98011
<br /> CONTRACTOR PHONE:425-806-9200 CONTRACTOR EMAIL:joanb@nwedison.com
<br /> nwedison.com
<br /> CONTRACTOR LIC.#(REQUIRED): NORTHEI983RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED):050699
<br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 425-806-9200
<br /> Joan Blacker CONTACT EMAIL:joanb C! nwedison.corn
<br /> AGREEMENT:l 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#
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<br /> Jf, l 2 E (�#6 -Ogg
<br /> ner /ori ed Agent Si•nature Date (Revised 9/23/2016)
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