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ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 l (E)everetteps@everettwa.gov I www.everettwa:gov/permits PROJECT Ott INFORMATION PROJECT ADDRESS: 170 0 1 `371I STRZE? COLRy BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPB 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: $COMMERCIAL USE OF BUILDING: . ::ELECTRI.CAL>APPLIcAT1'ON INFORMATION CONTRACT PRICE OF WORK:$ 300 00 NUMBER OF DEVICES(if low voltage): IFIRE ALARM? D YES in NO ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIPTION OF WORK: Install low voltage security system.-SEA- 17329 I 3714 Grasxr CA,m A OWNER NAME: Providence Medical Center TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET P.O. Box 1067 crrY Everett STATE WA LA 98206 OWNER PHONE: 425-261-3913 OWNER EMAIL: . CONTRACTOR NAME: Aronson Security Group CONTRACTOR ADDRESS: STREET 600 Oakesdale Ave. SW, Suite 100 CITY Renton STATE WA 7JP 98057 CONTRACTOR PHONE: 206-284-3553 CONTRACTOR EMAIL: pauL.aronson@aronsonsecurit .com CONTRACTOR LIC.#(REQUIRED): ARONSSGO13C6 CITY OF EVERETT BUSINESS LIC..#(REQUIRED):031987 PRIMARY CONTACT: 0 OWNER 17!CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-245-1441 Paul Aronson 1coNTACT EMAIL:paui.aronson@aronsonsecurity.com AGREEMENT:I hereby certify that!have reed and examined this application and know the same to be true and correct. Alf 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 lam authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# E 1512' Owner/Authorized Agent Signature Date (Revised 9/23/2016)