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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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1 717 Rockefeller Ave <br /> BUILDING AREA(if residential,new construction,remodel,or addition)_ SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL mow' <br /> USE OF BUILDING: Retirement Home <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2,500.00 <br /> NUMBER OF DEVICES(if low voltage): N/A <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Replacing the existing Dishwasher with a new Hobart unit- reducing the load. <br /> CONTACT INFORMATION <br /> OWNER NAME:Washington Oaks Retirement Home TENANT NAME(If Commercial):;_._ <br /> OWNER MAILING ADDRESS: STREET 1717 Rockefeller Ave <br /> cm, Everett STATE WA , zip 98201 <br /> OWNER PHONE: 425-339-3300 OWNER EMAIL: <br /> CONTRACTOR NAME: Cutter Electric, LLC <br /> CONTRACTOR ADDRESS: STREET PO Box 5789 <br /> .,.,,CITY Kent STATE WA LF 98064 <br /> CONTRACTOR PHONE: 206-859-7747 CONTRACTOR EMAIL: donley.zwart@cutterelectric.com <br /> CONTRACTOR Llc.#(REQUIRED): CUTTEEL933JS CITY OF EVERETT BUSINESS LIC.#(REQUI RED1.45940 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-859-7747 <br /> Donley Zwart CONTACT EMAIL:donley.zwart@cutterelectric.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 1C?),61 [0°1 <br /> - <br /> OwnerfAulharlzed Agent Signature Date (Revised 9/23/2016) <br />