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� LECTRICAL PERMIT A�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />ELECTRICAL APPLICATI4N INFORMATI�N <br />CONTRACT PRICE OF WORK: $3,000 <br />NUMBER OF DEVICES if low volta e: <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # if a licable : <br />DESCRIPTION OF WORK: 21F)24� - R@IOCate ower to emer enc anel <br />AGREEMENT. T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this <br />type of work will be comp/eted whether specified herein or not. The granting of a pe�mit does not presume to give authority to violate or cancel the provisions of any other state or <br />local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br />comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br />� Digitatty signed by Shannon Fuller <br />DN C,=US, E=Shannon.F@foygroup.net, <br />'� �" p-Fpy Group, OU=Project Manager, <br />f n r� a; . CN-$€�annon Fuller <br />ELECTRICAL I SOLAR I C�NTROLS� . ���• 2016.OZ2Z 0S:5J:11-OS�00� <br />Owner/Autnonzed Agent Signature Date <br />City of Everett Official Use Only <br />FEE <br />� � �-�) � <br />v � <br />PERMIT # <br />E �1��`� D e� <br />(Revised 10/12/2015) <br />