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4252503520 <br />�15. 37 a 02-17-2000 212 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />7720 1lardenson Road Suite D Everett, WA 98203 <br />PROJECT ADDRESS <br />Owner <br />Mcil Address <br />City <br />Slalefbp <br />Phone <br />FENL4 <br />7720 Hardenson Rd Ste D <br />Everett <br />WAJ98203 <br />Tenant <br />Ma,i Addmss <br />City <br />StalcrLio <br />Phone <br />Titan Electric, Inc. <br />12828 No thup Way Stuite 205 <br />Bellevue <br />WA/98005 <br />206-63 <br />3- e6 <br />Electrical Contractor <br />Mall Address <br />City <br />Slala/Tp <br />Phone <br />TITANE1963013 <br />051191 <br />State License Number (requimd) <br />Commercial <br />Prcposed Use of Building <br />Square Footage (If iosidential now construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done. <br />City of Everett Business License Number (required) <br />6,000 <br />Contract Price of Work <br />Lainissn Carroll / 206-735-9-198 <br />l uurissacoa)titanelcctric. net <br />Contact PersonlContact NumberlEmail <br />Install (1) 120v circuit. -Titan Job #146224 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have mad and oxaminud this application and know the same to be We and <br />cerract. All pmv,sions of Imes and ordinances governing this type of work will be completed <br />whathor spocihod harein or not. The granting old pound does not presume to give authority to <br />violato or concol the pmvisions of any other state or local law mgulating construction i the <br />parfonnanco of constnrction. That 1 am authonzed by the owner of this prapedy lope the <br />work for which application is made and/ comply with thin State Contractors Law 18.27 RCW and <br />295. 200 WAC. i <br />7 /�t:�L'�f` 2/17/15 <br />Slgnalure Dale <br />Laev:seo 04 M4 <br />FEE <br />rE <br />Mffri <br />I�OZ-Iz5 <br />