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Ah Ah <br /> 11111111111V Mr <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.arg <br /> 2215 Merrill Creek Parkway, Everett WA, 98203 <br /> PROJECT ADDRESS <br /> Polo Properties LLC R `�U Elk G,ryv.� C;cde. 5aku,l;,k (c)lCK- Ap 303 bdo 3W4o <br /> Owner Mail Address City State/Zip Phone <br /> Verizon Wireless MKS(oXXPc� ra t,�7 �l ct 2 kU �? 322. `tS`t 7 <br /> Tenant Mail Address City State/Zip Phone <br /> Strata Inc. PO Box 2988 Chelan WA/ 98816 425-259-6o16 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> STRATI*0201CN 00- `A r0 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Communications ��V �—Uy <br /> Proposed Use of Building Contract Price of Work <br /> Dan Dibble/ 36o-630-9334 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> ddibble(&stratainc.com <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: A"l 1 Lcl� S • j <br /> e ��ti� ��. ��'/ CG'S 5, a CC) ��w�0 5e CV ke_1 C <br /> 7f�T6j,,-1 1C-r <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Q <br /> 1 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. ile granting of a pernvt does not presume to gave authority to PERM! .# <br /> violate or cancel the provisions of any other state or local law regulating construction or the ^ i q I D i i <br /> performance of construction. That I am authorized by the owner of this property to perform the t lel• <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296 2no rA1AC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />