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4err ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> .-_.w., .pm i �i _ai ni ii , I,ip i �ti,>r_�. i a, 4N--rma i i ari v�.�, o uG ii �a iniii n �.._..... 6 i r,pi ii i i �,Nid iPi Poli:"�n ie �i _p qac w ii riliii <br /> �+. iii;Ii ri m IYi�w of nilitl,don is ilii oo , o P'' .N <br /> I p ilii � <br /> lliM�i� Iiu P 017 l R A ON <br /> It.Ii�''yU��,� NI�.t.�oU�J��6i�i - � }� .. ., .ul�;��n��i � t� ���II ens .. �i�i �- s„a�^�,.,r �`a <br /> PROJECT ADDRESS: 1809 Wall Street <br /> BUILDING AREA(if residential,new construction,remodel,or addition)1500. SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Used by City of Everett <br /> ELEC`TRICA�. IPPLICAT10�1INFORMATION <br /> CONTRACT PRICE OF WORK:$ 8,000.00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Existing service was disconnect for demo of building, City changed it's mind, re-hook up <br /> 400 amp service, <br /> CONTACT INFORMATION <br /> OWNER NAME:City of Everett TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3000 Rockefeller Ave <br /> c,,, Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-754-4709 OWNER EMAIL: l.gray@co.snohomish.wa.us <br /> CONTRACTOR NAME: Sequoyah Electric <br /> CONTRACTOR ADDRESS: STREET 15135 NE 92nd Street <br /> my Redmond STATE WA ZIP 98052 <br /> CONTRACTOR PHONE: 425-814-5864 CONTRACTOR EMAIL: don.lopata@sequoyah.com <br /> CONTRACTOR LIC #(REQUIRED): SEQUOEL976S9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED 04044 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-79-4956 <br /> Donald Lopata CONTACT EMAIL:don.lopata@sequoyah.com <br /> AGREEMENT:1 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# <br /> �-z �� 11 O$-02 <br /> Owner/Authorized Agent Si ature Date (Revised 9/23/2016) <br />