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Nov. 12, 2015 5: 52Av1 Sound Security Inc • No. 0198 P. 1/1 <br /> _........... .—.._....— t orf + `F <br /> ELECTRICAL PERMIT APPLICATION ' <br /> CITY OF EVERETT PERMIT SERVICES : <br /> • • 3200 CEDAR STREET, EVPRETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 r,www.everettwa.org :* <br /> 3 <br /> r .;: F 23v. 6rockii. <br /> * <br /> ' . <br /> PROJECT ADDRESS <br /> .r^Y <br /> Owner --. ) .,:,..,, <br /> Mail Addross City State/Zip ? Phone <br /> ..,, <br /> ......,-...- - .._-,9 ill r 4 ei5 2 r3CT•''''''1 <br /> Tenant Mail Address City State/Zip /Phune <br /> C !'Ir 01 0 ,.. s-. • ( `'_ttkor/c�.01- t�je . * ")S' f 2.5.5'--3(�S <br /> Electrical Contractor Mall Address ,• City State/Zip Phone •'s� <br /> • • --, q,3, <br /> cre-4 9(.[81)—I . J3J4J3 <br /> • State License Number(required) City of Everett Busiri ss License Number(required) <br /> t�.,s sir Q__(/),G15. . t 7 , 1 =`) <br /> • <br /> Proposed Use of Building Contract Price of Work ;i <br /> Square Footage(If residential new construction, remodel or•addition) Contact Peron/Contact Number/Email <br /> t <br /> It .y <br /> ' <br /> . i <br /> ' ; <br /> •Number of devices(If low voltage) • .`' <br /> Description of Work to Be Dane: 1 (Rik.),�,,�i V ( Fc32 r)(i <br /> (k/-_.,(',' f°,.J <br /> . • ' ) rka-.L. 'c...d-- -1_6-17:\- .31 <br /> . Cil <br /> FEE ;:, <br /> CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 • <br /> ' • <br /> x •, <br /> 1 horchy certify that I have read and examined this application and know the szmc to be true and �' <br /> correct, All provisions of laws and ordinances governing this type of work will be completed •'" <br /> r: <br /> • whether specified herein or not. Thr.: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 construction or the in <br /> perfonnanco of construction, That t am authorized by the owner of this property to perforin me E <br /> wank for which application is made and 1 comply with the Slate Con/ractors Law 18.27 RCW and ; <br /> 296.200 WAC. ' <br /> N <br /> .. .._._, l' 5--ctilg__. <br /> 1 .- ^Y� s <br /> _. _ ..._._...... .QTY <br /> Signature/ Date <br /> • REVISED 08/08/2014 • <br />