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age: 2 of 2 09/23/2016 <br />48276 <br />� <br />� <br />11:15 AM T0:14252578857 FROM: Mike Walker <br />�ECTRICAL PERMIT AP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />PHONE #360 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � wwrw.everettwa.gov/pert7tits <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ 300.00 <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: Add circuit for Ductless heatpump <br />AGREEMENT: T hereby certify thaf I have read and examined fhis applicafion and know the same to be true and correci. A!! provisions of laws and ordinances governing thrs <br />type of work will be completed whethe� specified herein or not. The granting of a permit does not presume to give autho�ity to violate o� cancel the provisions of any other state or <br />loca! !aw regu/atinq construction or the performance of construction. That I am aufhorized by the owner of this p�operfy to perform the work for which application is made and I <br />comply with fhe State Contractors Law 18.27 RCW and 296.200 WAC. <br />� !�(/G��%�- <br />9/23/206 <br />Owner/Authorized Agent Signature Date <br />City of Everett Officra! Use Only <br />FEE <br />/�, <br />� .-_-,--,- __�_- <br />�. <br />PERMIT # <br />E ��o� 6- �,� <br />(Revised 10/12/2015) <br />