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10/29/201a 01: �4Pn' 42535.33934 EVERGP.EEN SECURI7Y PaGE 02/�2 <br /> � s <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF E�'�P.cr.YT PEki.�IT SERVICES <br /> 3200 CEDAR STREET, EVERETT, Wr`.9Ei201 <br /> 425-257-8810 - FAX A25-257-8857—u�ww.everettwa.org <br /> �D _�p--lU <br /> 252► �a,��o �a 35 <br /> � Lombard Ave <br /> PROJECT ADDRESS <br /> Imrnanuel Luiheran Church - Everett 2525 Lombard Ave Everett. WA 425-252-7038 <br /> Owner MBiI Atltlress CVy SL�te/Zip Phone <br /> Immanuel Lutheran Church <br /> Tenant Ma�iAddress Ciry State2ip Phone <br /> Everqraen Security 8115 Broadway#101 Everett WA 9t3203 425-34f3-3850 <br /> Electrical Cont2clor h'a�i address Ciy StareR�p Pho�o <br /> EVERGSI112L2 0391 SC <br /> State Licens.e Number(required) Cily o(Eve:ett Businuss License Numbe�(requiretl) <br /> Commercial $520-00 <br /> Propesed Use of Building Contrar.t Pr�ce of VJork � <br /> lSarah J. Murrav 425348-3f350 <br /> SqUarO Foo�age Qf pe3id8t1tial n6w eonsirur,tion, �rt10d01 0��ddihon) COntact PersoNCon(ad NumbedEmpil <br /> I sarahm@ever•greensec��rity.com <br /> 2 <br /> Numberof devices pf lowvoltage) <br /> o�:9�r�puon orwor+c to o�oo�e: Low Voltage: Install Keypad in ViCCars Home (Downstairs) 8�Add <br /> Door Contaci in Church. <br /> FEE <br /> CITY OF EVERETi LOCAL SALES TNC CODE IS 9105 f� V� <br /> I hemby orortdy lhat I have read and ezainir,eA tr�is app�icstion and know fhe same(o be Uuo and ( <br /> coimcL All provisions oftaws and ordine^ces govoming Nris type ot��rork willbo eomplefed <br /> whcfher specified Iwruin or noL The prsnling o/o pormil doos not vmsume to yiva aufhanty t0 PERMIT# <br /> viofate or can�cl the provisions ol any othor sfate or loca/law rsgu/a6ng conslroetion or Ihe <br /> peAom�ance of conshucG'on. Thaf I am eu(horized by fhe owner ol fhis property fo peiform the E � f t.���Il _ Q 7J� <br /> work for whrch app�ica�ion is nmde ond 1 comply wrth the Sfote Cor.tfaCb�S Law 09.27 RCW dnd �� <br /> 296 200 WAC. <br /> I� �,Ic � <br /> SigN rc � Dale <br /> FEVREL�CC942c1[ -- <br />