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477 LLECTRICAL 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 1 (E)everetteps@everettwa.gov ( www.everettwa.gov/permits <br /> PROJECT E I11(IFORMATION <br /> PROJECT ADDRESS: 3003 w Casino rd 40-23 , 3 <br /> BUILDING AREA(if residential,new construction,remodel,or addi'on) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 15,000 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Interconnect pipe and wiring for automation tooling <br /> CONTACT INFORMATION <br /> OWNER NAME:Boeing Company TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET po box 3707 ms 1 f 09 <br /> seattle STATE wa Z,P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Electroimpact inc <br /> CONTRACTOR ADDRESS: STREET 4413 chennault beach rd <br /> crry mukilteo STATE wa ZIP 98275 <br /> CONTRACTOR PHONE: 206 353 4086 CONTRACTOR EMAIL:jasons@electroimpact.com <br /> lirCONTRACTOR LIC.#(REQUIRED): ELECTI8O55KA CITY OF EVERETT BUSINESS LIC.#(REQUIRE.:5 889 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206 353 4086 <br /> Jason Sloane CONTACT EMAIL:jasons@electroimpact.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 /> ViOd E n-01- <br /> Owne •uthorize. ‘+Signature Date (Revised 9/23/2016) <br />