4128 RUCKER AVE SAFEWAY 2019-07-24

A47"r' ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 4128 Rucker Ave. BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: m COMMERCIAL USE OF BUILDING: Grocery Store CONTRACT PRICE OF WORK: $ 6,500.00 NUMBER OF DEVICES (if low voltage): 21 FIRE ALARM? 0 YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Installation of Cat6 data cabling for(21) new security camera locations _.. 4,411. inNV:4:ZI,7077-7.14 :t.oNrA eIm R AtioN Y�� OWNER NAME:Albertsons Compaines TENANT NAME(If Commercial): Safeway OWNER MAILING ADDRESS: STREET PO Box 52142 c,n. Phoenix STATE AZ ZIP 85072-2142 OWNER PHONE: (425)201-6336 OWNER EMAIL: ryan.clevenger@safeway.com CONTRACTOR NAME: Pacific Communications Cabling CONTRACTOR ADDRESS: STREET 10522 E Riverside Dr. cin. Bothell STATE WA ZIP 98011 CONTRACTOR PHONE: (425)483-5957 CONTRACTOR EMAIL: administrator@pacificcc.com CONTRACTOR LIC.#(REQUIRED): PACIFCC910L5 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 035656 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (206)371-6630 Mike Lehtinen CONTACT EMAIL: mike@paCifiCCC.Com 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# 4 7/20/18 E \ 1Yl- 1 Owner/Aut�d ent Signature Date (Revised 9/23/2016)