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Mar, 14. 2016 3 : 001'M So id Security Inc No. 0226 F. 1 r' <br /> *_74 <br /> - ELECTRICAL PERMfTA ,PPLNCATION <br /> CITY OF EVERETTPERMIT SERVICES <br /> 3200 CEDAR.STREET, EW �,ETT, WA 98201 <br /> 425-257-8810 -',,FAX 425-257.8 57�w,wyvw-everettwa.org <br /> PROJECT ADDRESS <br /> Mail Address City State/ZJp "one <br /> Owner <br /> enant (f Mail Address i, City Sfafelz3p f r Phone <br /> 60 <br /> Mail Address i City state/Zip Phone <br /> Electrical Contractor 1. <br /> f 3 <br /> (7 City of Ever tt Huslne License Number(required) <br /> State License Number(required) <br /> < J <br /> �ryr1 Contract Price of Work <br /> Proposed se of Building <br /> �S I C 5s <br /> Square Footage (If residehtial new construction, remodel or addition) <br /> Contact Per on/Contact Number/Emall <br /> 3 <br /> Number of devices (If low voltage) <br /> Se <br /> of Work to Be Done: 1 <br /> bescnptlpn <br /> FEE <br /> o <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ✓� � <br /> me to be free and <br /> I hereby certify that I have read and examined this application and know the sa <br /> correct. All provisions of laws and ordinances goveming this type of work will be, completed <br /> whetherspecified herein or not. The granting of a permit does not presume to give authority to PERMIT D <br /> viviate or cancel the provisions of any otherstate gr1gcal law regulating construction or the T=Nf L <br /> performance of construction. That I am authorized by the owner Df this property to perform the "1[ <br /> work for which application is made and I comply with the State Contractors Law 18,27 RCW and <br /> 296.20 WAC• f <br /> Signature <br /> 1 . <br /> �EVISEo tleiu6/2o7G <br />