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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES i <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />E) so S-a5S� <br />9506 19th Ave Se <br />PROJECT ADDRESS <br />AT&T Mobility PO Box 66786 Saint Louis MO/63166 --- <br />Owner Mail Addnss City State/Zip Phone <br />AT&T Mobility PO Box 66786 Saint Louis MO/63166 n°...... <br />Tenant Mail Address City StatolZip Phone <br />MacDonald Miller 7717 Detroit Ave S Seattle WA/98106 --- <br />Electrical Contractor Mail Address City State/Zip Phone <br />MACDCMF972BF 040665 <br />State License Number (required) City of Everett Busine : License Number (required) <br />COMMERICAL $1,000.00 <br />Proposed Use of Building Contract Price o Work <br />NA Clayton Parker 206-768-3934 <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />1 <br />Number of devices (If low voltage) <br />Provide & install power for (2) HVAC Split units. (2) 208 volt, 1 phase, <br />Description of Work to Be Dane: <br />40 amp circuits (outdoor units), (2) 208 volt, 1 phase, 15 amp circuits (indoor units). <br />(1) 120 volt convenience receptacle, Low voltage wiring (1 low voltage controller) f <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this typo o/work will be completed <br />whether specified heroin or not. The granting of a permit does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construction or the r D r D �� <br />performance of construction. That I am authorized by the owner of this property to perform the t <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />5/12/2015 <br />Signature Dale <br />REVISED O&W7014 <br />