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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 414 Rockefeller Ave, Everett, WA 98201 <br /> PROJECT ADDRESS <br /> Ruslan Nesterenko 414 Rockefeller Ave Everett WA 98201 (425) 359-8499 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> A&R Solar 2444 1st Ave S Seattle WA 98134 206-707-9937 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 602-707-872 053961 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Residential Home 41-7-4-7-5700-_ 4,15 o0,()° <br /> Proposed Use of Building Contract Price of Work <br /> Jesse Anderson (206)-317-4656 <br /> jesse@a-rsolar.com <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Installing a 8.960 kW Photovoltaic System on the roof. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,1L /�j' (cc <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein 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 I O �^ <br /> performance of construction. That I am authorized by the owner of this property to perform the t I�-J� _ fL <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 10/28/2015 <br /> Signature Date <br /> REVISED 08/06/2014 <br />