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4477 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: EWPCF 4027 4th St SE <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 <br /> USE OF BUILDING: Wastewater Treatment Plant <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 25,000 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES m NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install 3 ea new sodium hypochlorite pumps, wiring, conduit, and controls I <br /> CONTACT INFORMATION <br /> OWNER NAME: City of Everett TENANT NAME(If Commercial): EWPCF <br /> OWNER MAILING ADDRESS: STREET <br /> 3002 Wetmore Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> fi <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: OWNER <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-257-7847 <br /> Andy Dorsey CONTACT EMAIL:adorsey@everettwa.gov r, <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 t am authorized by the owner of this property to perform the work for which application is made and <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 10/11/2017 E 'D <br /> Owner/Autho��=d Agent Signature Date (Revised 9/23/2016) <br /> 4 <br />