2201 WETMORE AVE CANYON CREEK CHURCH 2019-06-25

4"7 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2201 Wetmore Ave BUILDING AREA(if residential, new construction,remodel,or addition)4950 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL USE OF BUILDING: Church ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 10,000 NUMBER OF DEVICES (if low voltage): 20 LV, 20Recepticles, 6 Light Switches FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): B-1803-010 DESCRIPTION OF WORK: Install of 20 receipticles, 20 LV data boxes, and 6 light switches. CONTACT INFORMATION OWNER NAME: CAt4 004 CI(L.E£ CtkN, 4 TENANT NAME(If Commercial): Canyon Creek Church OWNER MAILING ADDRESS: STREET 15117 Main St Suite B205 c,N Mill Creek STATE WA zip 98012 OWNER PHONE: 425-418-7477 OWNER EMAIL: paul.w@canyoncreekonline.com CONTRACTOR NAME: C)Lu CONTRACTOR ADDRESS: STREET CITY STATE WA ZIP 98012 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-314-4963 Shawn Pederson CONTACT EMAIL: 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 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# E -10 Owner/Authorized Agent Signature Date (Revised 9/23/2016)