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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 /> 10200 19TH AVE SE <br /> PROJECT ADDRESS <br /> COSTCO WHOLESALE CORP, 999 LAKE DR, ISSAQUAH, WA 98027 <br /> Owner Mail Address City State/Zip Phone <br /> S/A <br /> Tenant Mail Address City State/Zip Phone <br /> SMITH FIRE SYSTEMS, INC., 1106 54TH AVE E, TACOMA, WA 98424 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> SMITH FS861RS 23577 <br /> State License Number(required) City of Everett Business License Number(required) <br /> RETAIL 3896 <br /> Proposed Use of Building Contract Price of Work <br /> SCOTT JERKE 253-248-2004 <br /> 1284 SJERKE@SMITHFIRE.COM <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 3 <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: THE SCOPE OF THIS PROJECT IS TO ADD NOTIFICATION AND INITIATING DEVICES <br /> FOR THE PURPOSE OF TENANT IMPROVEMENT. ! -Fy y 1A/Vk4/ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 l1 <br /> 5 I j <br /> 1 hereby certify that I have read and examined this application and know the same to be true and �J <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction_ That I am authorized by the owner of this property to perform the 1 02r 0 1 <br /> work for which application is made and omply with the State Contractors Law 18.27 RCW and �i! <br /> 296.200 WAC. (o `_ (U) <br /> vC (---C L_�_ M15/l16%�li� <br /> • 5 nature Date <br /> REVISED 08/06/2014 <br />