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APPLICATIC,J FOR ELECTRICAL F RMIT <br />Lri 0 � CITY CF I ) <br />eVePett Al BAN 1.5 �� z ' <br />C H BUILDING DEPARTMENT CITY pf EVERETT <br />............. <br />................... <br />259-8810 <br />sxs Public Works Dept. <br />H x H <br />I! 0 <br />H �1 <br />H Mr. Ross Perry 3421 Rockefeller Everett 98201 252-4986 <br />F-3 CA 1"1 a rer ---Mali Address ty Zip hone <br />pxo Mr. Ross Perry 3411 _ <br />O H t7 enant a ress ty p hone <br />WH IA 0 g Evergreen Security 8229-D 44th Ave W Alukilteo 98275 348-3850 EVERGSI112L2 <br />a. 0 Electrical Contractor Mail Address City Lip Phone <br />License III <br />z I -I $1245.00 Residential <br />H Contract Price o or <br />� IZD roposc se o III d ng <br />g to Rockefeller Everett, WA 98201 <br />~ Project Address <br />0 t7 Tn -- <br />t" Low voltage alarm system installation <br />2 H N Tscr pt on of or o c one: <br />HOTn <br />NOTE: WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, <br />INSTITUTIONAL OR HEnLTH CARE FACILITIES <br />low <br />�_ <br />BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED ILANS BEFORE A <br />1 <br />CITY OF EVERETT PERMIT WILL BE ISSUED. <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO BE IN CONDUIT. <br />� <br />nl <br />i <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO "E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCFS GOVERNING THIS TYPE OF <br />low <br />I <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />�I <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />FEE $30.00 <br />�I <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296,200 WAG. <br />Signature Date <br />