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07/15/2014 14:11 FA1 4253399244 Canon 2020i <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 />1122 75th St SW, Everett, WA 98203 <br />PROJECT ADDRESS <br />Canyon Creek Church <br />Owner <br />Tenant <br />1122 75th St SW <br />Mall Address <br />Mail Address <br />Eve rett <br />City <br />City <br />WA 982Q3 <br />State/Zip <br />State/Zip <br />17�.J00��1./0001 <br />425)903-4189 <br />Phone <br />Phone <br />Williams Mechanical, Inc, 3903 Smith Ave Everett WA 98201 (425) 303-0828 <br />EleCtriCal ContrBCtOf Mail Address City State/Zip Phone <br />WILLIMI894C5 <br />State l�icense Number <br />Ch u rch <br />Propased Use of Building <br />Square �ootage (if residential new construction, remodel or addition) <br />15 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: Thermostat wiring multizone <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Dan Sanders <br />Contact Person (Plan Review) <br />l hereby certify that / have read and examined this application and know the same fo be frue and <br />cor�ect. All provisions of laws and ordinances goveming this type of worlc wi116e completed <br />whether specified herein or not. Tire granting of a permit does not presume fo give authority to <br />violate or cance! ihe provisions of any ofher state or local law regulafing construction or the <br />performance of construction. That I am aufhorized by the owner of tiris property to perform the <br />woric for which applicafion is made and l comply with fhe State Confractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />az�.��� a�'�� �- /�5 —/ <br />Signature Date � <br />Reviseo sna,s <br />FEE <br />� L� C� <br />PERMIT# <br />E I��`1'�� <br />