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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 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1 102 Shuksan Way <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ® COMMERCIAL <br /> USE OF BUILDING: Machine Shop <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 9000 <br /> NUMBER OF DEVICES (if low voltage): 2 <br /> FIRE ALARM? 0 YES 71 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Install (1) 60amp 120/208 volt circuit for lathe, and (1) dedicated circuit and receptacle for band saw. <br /> CONTACT INFORMATION <br /> OWNER NAME: Joe Johnson TENANT NAME(If Commercial): Terry's Machine and Mfg. <br /> OWNER MAILING ADDRESS: STREET 1102 Shuksan Way <br /> cin Everett STATE WA Zip 98203 <br /> OWNER PHONE: 425-349-2705 OWNER EMAIL:JJohnson@terrysmachine.com <br /> CONTRACTOR NAME: Titan Electric Inc <br /> CONTRACTOR ADDRESS: STREET 12828 Northup Way, Suite 205 <br /> ciTv Bellevue STATE WA zip 98005 <br /> CONTRACTOR PHONE: 206.633.8211 CONTRACTOR EMAIL: permits@titanelectric.net <br /> CONTRACTOR LIC.#(REQUIRED): TITANEI963OB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051191 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206.633.2811 <br /> Linda Anderson CONTACT EMAIL: lindaa@titanelectric.net <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 /> � ao.mna PERMIT# <br /> Linda Anderson :20181019000�so,oa <br /> E i(J -( 6,t , -2) <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />