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ELECTRICAL PERMIT APPLICATION <br /> 477 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: V$IO AIRPoOT RD. 6v&RCr IAA 9$ZOLI S744' 7017 <br /> BUILDING AREA(if residential, new construction,remodel,or addition)400 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: El COMMERCIAL <br /> USE OF BUILDING: Community Transit bus shelter <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ $5,000.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES m NO � (` <br /> ASSOCIATED BUILDING PERMIT#(if applicable): b' (l.0 2 <br /> DESCRIPTION OF WORK: Construction of new ous shelter electrical service for lighting and passenger information display. <br /> 120/240 Volt single phase 60Amp new meter and service <br /> CONTACT INFORMATION <br /> OWNER NAME:Community Transit TENANT NAME(If Commercial): Todd Jacobs <br /> OWNER MAILING ADDRESS: STREET 7100 Hardeson Rd <br /> CITY Everett STATE Wa ZIP 98203 <br /> OWNER PHONE: 425 348 2367 (OWNER EMAIL:todd.jacobs@COmmtranS.org <br /> CONTRACTOR NAME: Elcon Corporation <br /> 0801 2.7r4 Dr IW 5-ate I op <br /> CONTRACTOR ADDRESS: STREET 1 -- - 93 <br /> CITY Everett STATE Wa• ZIF <br /> CONTRACTOR PHONE: 206 510 3087 (CONTRACTOR EMAIL: bjudge@eICOnCOrp.COm <br /> CONTRACTOR LIC.#(REQUIRED): ELCONC*128J1 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 014943 <br /> PRIMARY CONTACT: 0 OWNER ,RI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206 510 3087 <br /> Brandon Judge CONTACT EMAIL:bjudge@elcorlCOrp.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 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ç1144Revised 9/23/2016) <br /> Owner/ uthorized Agent Signature Date <br />