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4t-rr 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 1 (E) everetteps@everettwa.gov I vwvw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3003 West Casino Rd Everett WA 98204 - Parcel #: 28041000100200 <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: El COMMERCIAL <br /> USE OF BUILDING: manUfaCtUring,.r, -\ 40_54i /544. 77-7X r B LL. <br /> ( ,;/ ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK,1$ 19,868.00 <br /> i <br /> NUMBER OF DEVICES (if lovfi voltage): N/A ,/ <br /> FIRE ALARM? D YES 1 ,140 <br /> ASSOCIATED BUILDING PERMIT#of applicable): N/A <br /> DESCRIPTION OF WORK: Installation of 8 control panels <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing TENANT NAME(If Commercial): Boeing <br /> OWNER MAILING ADDRESS: STREET 3003 West Casino Road <br /> cin Everett STATE WA Z,P 98204 <br /> OWNER PHONE: Tom Baggott 425.237.7756 OWNER EMAIL: thomas.g.baggott@boeing.com <br /> CONTRACTOR NAME: Custom Controls Corporation dba Custom Electric &Controls <br /> CONTRACTOR ADDRESS: STREET 4630 - 16th Street East Suite# B-24 ti�+�+ <br /> CIT ,Y Fife STATE WA ZIP 94266 <br /> CONTRACTOR PHONE: 253-922-5874 CONTRACTOR EMAIL: tammys@customec.com <br /> f <br /> CONTRACTOR LIC.#(REQUIRED): CUSTOCCO752D CITY OF EVERETT BUSINESS LIC.#(REQUIRE ): 05094 _" <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-310-3195 <br /> Cameron L Stickel) CONTACT EMAIL: KevinM@customec.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 /> 07-- <br /> 4 _ 6,0, /0 7-ki164 <br /> ES , 0S9 <br /> uthorized Agent Sig ture Date (Revised 9/23/2016) <br />