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09/29/2015 16:27 Page 2/2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-6810 - FAX 425-257-88577 -www.everettwa.org <br /> -9,9("7 <br /> 1 HW Ave <br /> PROJECT ADORMS <br /> Schack Art Center 2921 Hoyt Ave Everett WA 98201 425-2695050 <br /> Owner Mall Address Guy slatelLp Phone <br /> Same <br /> Tarrant Mail Addmas city stalealp PhW0 <br /> Evergreen Security 8115 Broadway#101 Everett VVA 98203 425-348-3850 <br /> ElectdcalContr=tDr Mail Adds city stwaaip Pilo,* <br /> EVERGS11 121.2 039 160 <br /> State Licame Number(required) City of Everett Business License Number(required) <br /> Commercial $5568.00 <br /> Proposed Use of Building Contract Price-of Work <br /> Mg[y Kelp 425-348-,3850 <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> accounting@ eve rg re ensecurity,com <br /> 9 <br /> Number of de-vices(if low voltage) <br /> DesciiPtion of Work 10 80-Done: Installation of Access Control far Security Gate and Wiral"s panlos& <br /> Installation of Customer CCTV System <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 FEE <br /> I hereby certify that[have read and examined Ws appffcatior?and Mow the same to ba true and <br /> correct. Ad provisions of laws and ordinances 9ovvnWnV this We at`wank wilf,be cmpAsted <br /> whathar specified herein or not. The granting o1a pormilt does n&pyewm&to give authority to PERMrT* <br /> vkWate arcano9l the provisions of any oftrstat&or toil low regulaung consUWintr orlhe <br /> pertbirmanceofcorarvc&n, That I am afithorized by O�e ovmerof VVs ptopedy�o pworm the E-13 150�-()/t( <br /> work for which applkation Is made and)comply with the State Contract=Law 18.27 RCW and <br /> M200 W,41C., <br /> %14U&j1j <br /> skjAelum zr the f <br /> AaNrab O& anis <br />