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08-19-16; 10: 47AM; From:Evergreen Security Inc. To: 4252578857 4253538934 2/ <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—wwvt.everettwa,org <br /> r414 roadway <br /> PROJECT ADORE <br /> CM Heating a 91-4-Broadway Everett WA 98201 425-259-0550 <br /> Owner Mall Address City StatelZip Phone ! <br /> Same as above / <br /> Tenant Aaeress Clry StatetZlp Phone <br /> Evergreen Security 8115 Broadway#101 Everett WA 98203 425-348-3850 <br /> Electrical Contractor Mall Address City Siete/23p Phone <br /> EVERGSI112L2 039160 <br /> State License Number(required) City of Everett Business License Number(required <br /> Commercial $2300.00 <br /> Proposed Use of Building Contract Prig of Work <br /> Mary Ke1p.425-348-3850 <br /> Square Footage(If residential new construction,remodel oradditian) Contact Person/Contact NumberIErnail <br /> accounting@evergreensecurity.com <br /> 13 <br /> Number of devices(If low voltage) <br /> Description of Vltoric to Be Done: Installation of Security Alarm System <br /> • <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 \,S .0 0 <br /> !hereby certify that I have read ancf examined this application and know the same to be true and <br /> correct. ANArovfsions of laws and oh7inanCas gOVerninft MIS 49e of work wild bo colnplated <br /> - <br /> wether specified herein or not The granting of a pormit does not presume to give authority to PERMITf <br /> violateorcanceltheprovisionsofanyrothersteleortoes!lawregulatingconstructionorthe ( �©�r D `� <br /> performance of corrsfh <br /> lruction. That t am aunrizari by the owner of this property to perform the <br /> work for which application is made and I compry with the State Contractors Law 18.27,RCW end <br /> 296.200 AC <br /> (-A-A6-)V-OS <br /> t I CI 1 <br /> Signature T <br /> Dat LL <br /> hit Vl JLu O W)6r2O14 <br />