Laserfiche WebLink
E ECTRICAL PERMIT APF1ICATION <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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 4201 Rucker Ave <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: VI COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 100.00 <br /> NUMBER OF DEVICES(if low voltage): 2 <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install 2 lit wall signs <br /> CONTACT INFORMATION <br /> OWNER NAME: Community Health Center TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4201 Rucker Ave <br /> c,T„ Everett STATE WA zip 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Berry Sign Systems <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> crry Everett.__ __-- - STATE WA zip 98203 <br /> CONTRACTOR PHONE: 425.776.8835 CONTRACTOR EMAIL: tracies@berrysignsystems.com <br /> CONTRACTOR LIC.#(REQUIRED): berrySs853w7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 24786 <br /> PRIMARY CONTACT: ❑OWNER Ql CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 x 114 <br /> Tracie Skiles CONTACT EMAIL:tracies@berrysignsystems.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 WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E \ c9 - d-- f <br /> Owner/•ut or -d c Signature ..---(D'ale(t (Revised 9/23/2016). <br />