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ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
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<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
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<br /> PROJECT ADDRESS: 3409 McDougal Ave 1
<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: Warehouse
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<br /> CONTRACT PRICE OF WORK: 3500.00
<br /> NUMBER OF DEVICES (if low vo age): 10
<br /> FIRE ALARM? II YES 0 '0
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: Replace Existing Fire Alarm System.
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<br /> OWNER NAME: Glacier Properties, LLC TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET 3409 McDougall Ave, Suite 200
<br /> CITY Everett STATE WA ZIP 98201
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: Fire Systems West, Inc.
<br /> CONTRACTOR ADDRESS: STREET 206 Frontage Rd N, Suite-C
<br /> CITY Pacific STATE WA ZIP 98047
<br /> CONTRACTOR PHONE: 253-833-1248 CONTRACTOR EMAIL: service@firesystemsweSt.com
<br /> CONTRACTOR LIC.#(REQUIRED): FIRESWIO55LW CITY OF EVERETT BUSINESS LIC.#(REQUIRED 02291
<br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 253-951-6005
<br /> Matt Carlman CONTACT EMAIL: mattc@firesystemswest.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 /> 7PERMIT#
<br /> 77f47/7 4'4 E `' ,O — 02-4
<br /> Owner/Au orized Agent Signature D to (Revised 9/23/2016)
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