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I 1'�pf.,� - � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEUAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-25i-8857—www.everettwa.org <br /> I <br /> 11126 Evergreen Way Everett tNA 98204 - BLDG D <br /> PROJECT ADDRESS <br /> Coast Real Fstate Services 2g2g Rucker Ave Everett W/�1, 98201 <br /> IOwner Mait adarese C�ry Stat�p Pnone <br /> Evergreen Center- BLDG D 91126 Evergreen Way EV@t"@tt VYQ, 98204 °"'°°°` <br /> Tenant Meil Atltlress c�ry Statc2ip pnone <br /> GUa�dl811 SG'CUCity 1743 First Avenue South Seattle �A, 98134 ����� <br /> Elef:lncal Conhactor Mall AddrpSs Cdy Statef7.ip Phone <br /> 033443 250.00 <br /> IState License Nurn6er Contrad Pnce of Work <br /> Building Casey Walsh <br /> Proposed Use of Building ContaC Aersan (Plan Review) <br /> � GOOO <br /> Square Footage Q(residential new constructton,remodel or addition) <br /> 1 <br /> Number of devices(If low wltege) <br /> Installation of leased AES radio to replace scan monitoring <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��/�� <br /> 1 hereby caifify fhat I nave reed and exeminod U�is epplication and know t�e same to be true end v <br /> correc(. AIf provisions of laws and ordinances goveming fhis type o(work wi�!be completed <br /> whethor specffied herain or no[ The grsn;ing a1 s permi(does not presume ro give authoriry to PERMIT# <br /> v�olate cr cance�U�e provisions of eny otl�er siate o�locel lew raguleNng constructlon or the E � 3 I I - 0�S <br /> performance ol conshuctlon, TM1ar i am eurhonzed by the oWner ol this property fo peAorm Ihs <br /> woAc/or whlch apphca(lon is made 6nd f comply witA tlre Stete ConheCtors Law 18.27 RCW aqd <br /> 296.200 WAC. <br /> v' 11 /12/2013 <br /> S�grfatu2 `� Date <br /> R='��SEDYm�J <br />