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071Err I L.ECTRICAL PERMIT AP ICATION <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: 3003 West Casino Rd Building 45-235 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: a COMMERCIAL <br /> USE OF BUILDING: Aerospace <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 750 <br /> NUMBER OF DEVICES (if low voltage): 1 Tstat <br /> FIRE ALARM? 0 YES a NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Install 1 thermostat for heat pump <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 M/C 6A1-01 <br /> CITY Seattle STATE WA ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Johansen Mechanical, Inc. <br /> CONTRACTOR ADDRESS: STREET 20109 144th Ave NE <br /> CITY - Woodinvill STATE WA ZIP 98072 <br /> CONTRACTOR PHONE: 425-481-2266 CONTRACTOR EMAIL: ivyl@johansenmech.com <br /> CONTRACTOR LIC.#(REQUIRED): IOHANMI969P7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 024276 <br /> PRIMARY CONTACT: 0 OWNER COCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> 425-481-2266 <br /> Ivy LeVangie CONTACT EMAIL: ivvl@iohansenmech.com <br /> AGREEMENT:T hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> 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 <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 /> FEE yr`� <br /> PERMIT# <br /> ( 1 -01 E /-9 <br /> 0.114/Authorized Agent Signature Date (Revised 10/12/2015) <br />