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477- 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: /183( /f2RPd(ZT R . Ebr 2k-r; 6✓i. 9g7°q sT,a,z* 30Z I <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: I 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): C t ( r2- o' o <br /> DESCRIPTION OF WORK: Construction of new bus 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 /> CONTRACTOR ADDRESS: STREET 5601 23)4 Dr' W Suri /00 <br /> CITY Everett STATE Wa. ZIP 7(52-03 <br /> CONTRACTOR PHONE: 206 510 3087 CONTRACTOR EMAIL: bjudge@elconcorp.com <br /> CONTRACTOR LIC.#(REQUIRED): ELCONC*128J1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 014943 <br /> PRIMARY CONTACT: 0 OWNER l l CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206 510 3087 <br /> Brandon Judge CONTACT EMAIL: bjudge@elconcorp.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 lam 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 /> 10/�l-� E <br /> Owner/Authorized A ent Signature Date (Revised 9/23/2016) <br />