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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 South Cabot Rd. Everett, WA 98203 <br /> PROJECT ADDRESS <br /> Jason Meshke 414 South Cabot Rd Everett WA 98203 425-789-9567$ <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Andgar Corporation PO Box 2708 Ferndale WA 360-366-9900 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ANDGAC*011L5 <br /> $6, 622. 98 <br /> State License Number Contract Price of Work <br /> single family dwelling <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> 1 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: T-Stat Retrofit Heat Pump <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 15 500 <br /> I hereby certify that t 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 <br /> performance of construction. That I am authorized by the owner of this property to perform the ERI502-009 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,ar //_ 02/09/2015 <br /> Signa re " Date <br /> REVISED 3/20/13 <br />