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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 FM 425 257-8857 1 (E)ever+ ttepteeVer ftwagOv I iMivw:everetlwa.goviperrrnits <br /> PROJECT SIE INFORINIATION <br /> PROJECTADDRESS: 3520 Railway Ave; <br /> BUILDING AREA(if residential;new construction,remodel,or addition) SF <br /> BUILDING TYPE: D SFR-DETACHED Cl SFR-ATTACHED- 0 DUPLEX Ca MULTI=FAMILY- OF UNITS:: ®CQMMERCIAL <br /> USE OF BUILDING: Lift Station 32 <br /> ELECTRICAL,APRL1cATION 11+ F 11 ATIION <br /> CONTRACT PRICE OFWORK:$ 500 <br /> NUMBER O.l=DEVICES(If IOW Voltage) <br /> FIRE ALARM?: CD.YES 0-NO <br /> t <br /> ASSOCIATED BUILDING PERMIT lrf pplicable); <br /> DESCRIPTION OF,Wc:RK. load barlk=lest on new,generator <br /> CONTACT INFORMATION <br /> OWNER NAME:City Of Everett TENANT NAME.(It.CommercIaI): <br /> OWNER MAILING ADDRESS:: STREET 3520 Railway Ave <br /> ci ,Everett, srATe..Wi4 zip 98201 <br /> OWNER PHONE: !OWNER EMAIL <br /> •CONTRACTOR NAME: Cummins Inc <br /> CONTRACTOR ADDRESS: STREET'1890 FrY cr Aifiti <br /> cnv;'Sur1lrltrrSTATE WA zip 98390 <br /> CONTRACTOR PHONE:.425-277-5343' CONTRACTOR:EMAIL: ,dan.vvaSsom@CUrnmins.com <br /> CONTRACTOR LIG.#CREQUIRED): CUM MII*853C4 CITY OP EVEREiT BUSINESS UC:*(REQUIREDy:'049363' <br /> PRIMARY CONTACT: D OWNER. ®CONTRACTOR . Tt ER(PIease Specify)_ <br /> T <br /> CONTACT NAME: CONTACT PHONE: 425,277,5343 <br /> -CCONTACT E**1-.clartAfirass0rnl tlrffri irIS.Ort <br /> AGREEMENT thereby certifythatI have read and exer ted this;apphcatfott,and kncnx.the same t©be tare and correct.,Alt prov(sions of laws and ofd nances governing this type <br /> of work,wild be completed whetherspecifredherein otnet The:grantingcla does ropresumetogiveauthoidytoviotaterorcencaeltheprovisionsdfanyeetherstateor <br /> local law regulating construction or the performance ofco structwn ThatMal I Mir authorized.by lhe.nhenerof this property tirpesform.the walk far which application is made and t <br /> comply with the State Contractors Law 18,27 RCUYand 296200 WA <br /> O'ty of Everett Official one Only <br /> 1,1E711'4 <br /> (''' '-ri,,,ii t''' 4,--....---- i 2,1()t14'7 <br /> ,,,) <br /> ovmet`4lluthorizomaent SignatureDate (Revised 912310161 <br />