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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov l www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10303 19th Ave. S.E., Everett, WA 98208 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: VI COMMERCIAL <br /> USE OF BUILDING: Professional Building (Chiropractor, Dentist Offices) <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1200 <br /> NUMBER OF DEVICES (if low voltage): 1 <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): N/A <br /> DESCRIPTION OF WORK: Installing new Telguard Cellular Communicator in existing building to upgrade existing <br /> fire alarm system monitoring. <br /> CONTACT INFORMATION <br /> OWNER NAME: Stacey Urn LLC TENANT NAME(If Commercial): 10303 Professional Building <br /> OWNER MAILING ADDRESS: STREET 3807 187th PI. S.E. <br /> CITY Bothell STATE WA zIP 98012 <br /> OWNER PHONE: 425-773-7885 OWNER EMAIL: <br /> CONTRACTOR NAME: Protection & Communications, Inc. (Pro-Comm) <br /> CONTRACTOR ADDRESS: STREET 19630 40th Ave. W. <br /> CITY Lynnwood STATE WA ZIP 98036 <br /> CONTRACTOR PHONE: 425-774-9099 CONTRACTOR EMAIL: lylew@pro-Comm-online.com <br /> CONTRACTOR LIC.#(REQUIRED): PROTECI165L8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 026474 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-593-5544 <br /> Lyle Wells CONTACT EMAIL: lylew@pro-comm-online.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 /> s zc ; e E1 (60(6`2D6 <br /> Own- !•.. • .�•.e. Ir• ature Dat (Revised 9/23/2016) <br /> \ h <br />