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� � <br />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 />3927 Rucker Avenue Everett, WA 98201 <br />PROJECT ADDRESS <br />Everett Clinic 3901 Hoyt Ave Everett <br />Owner Mail Address City <br />Everett Clinic - Gunderson 3927 Rucker Ave E�✓erett <br />Tenant Mail Address City <br />Guardian Security Systems, ���. 1743 First Ave S. Seattle <br />Electrical Contractor Mail Address <br />GUARDSS233K5 <br />State License Number (required) <br />Hospital <br />Proposed Use of Building � �� <br />2�00 <br />Square Footage (If residential new construction, remodel or addition) <br />2 <br />Number of devices (If low voltage) <br />City <br />WA, 98201 :�.� �,�3°5l <br />State/Zip Phone <br />W/� ' � j� L o � 41` 317-3651 <br />� � tJ <br />StatelZip <br />WA/98134 <br />State/Zip <br />Phone <br />Phone <br />033443 <br />City of Everett Business License Number (required) <br />�50.0� <br />�:ontract Frice of Work <br />Karina Veliz/(206) 349-5889 <br />Contact Person/Contact Number/Email <br />Installation of 2 d�vices -(1) Smoke Detector and (1) str��� <br />Description of Work to Be Done: <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 type of work will be completed <br />whether specified herein or not. The granting of a permit d�es not presurne to give authority to <br />violate or cancel the provisions of any other state or /ocal law regu7ating ca�istruction or the <br />performance of construction. That 1 am authorized by the owner of tl�is property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� , <br />.� � , ;(^ � 1/16/2014 <br />; '� ! • �, :�__/ - <br />re <br />� <br />REVISED 08/O6/2014 <br />FEE <br />��� <br />PERMIT# <br />E ���� �0�(� <br />