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Jan, I. 2016 1 45P So u n d Security Inc _ �,,No, 0214—P, 2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV FETT, WA 95201 ` <br /> 425-257-8810 -' FAX 425-257-8857, -,www.everettwa.org <br /> • <br /> PROJECT ADDRESS <br /> Owner Mall Address / City StateJ�ip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 2,5Z-3(PS5 <br /> Electrical Contractor Mail Address City State/Zip Phorie <br /> 13 ) q 5 <br /> State License Number(required) �r City ofgEverutt Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Con <br /> Square Footage (If residential new constructiion,remodel or addition) tact Per on/Contact Number/Email <br /> {Vumb�er of devices (If low voltage) <br /> c ,t <br /> Description of Work to Be Done: . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX COTE 15 3105 r F <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ord/trances goveming 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 construcfion or the <br /> perfor mance of construction. That I am authorized by the owner.of this property to perform the <br /> work rorwhich application is made and I comply with the State Contractors Law 98.27 RCWand <br /> 296-20 WAC. a <br /> Signature 'Date <br /> R6V/SED 061VW2014 <br />