12906 19TH AVE SE 2019-08-13 - Laserfiche WebLink

_ 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 www.everettwa.gov/permits c6PROJECT SIVE INFORMATION PROJECT ADDRESS: 12906 BUILDING AREA(if residential, new construction, remodel,or addition 2500 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Retail ELECTRICALAPPLICATION'INFORMATION CONTRACT PRICE OF WORK: $ 000 NUMBER OF DEVICES (if low voltage): 13 FIRE ALARM? 0 YES ® NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Installation of security equipment CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): Fred Meyer-Mill Creek OWNER MAILING ADDRESS: STREET CI TY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Asset Protection Partnership CONTRACTOR ADDRESS: STREET PO Box 349 c,ry Forest Grove STATE OR ZIP 97116 CONTRACTOR PHONE: 503-359-4344 CONTRACTOR EMAIL: carmenl@appltd.com )‘O i Y CONTRACTOR LIC.#(REQUIRED): C Y '° Q j- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): rf: PRIMARY CONTACT: ®OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTAC'PHONE: 503-359-4344 Brian Dickinson CONTACT EMAIL:briand@appltd.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 dyes riot 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 f PERMIT# , _.11101r, E Qi600061 Owner/Authorized Agent Signature Date (Revised 9/23/2016)