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0511912015 16: 30 3606500,207 WHITE SECURITY SYS P-AGE 01/01 <br /> _ 0 0 <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 /> PROJECT ADDRESS <br /> 120 rr,*" g820:� <br /> Owner Mail Address City Steteizip Phone <br /> Tenant Mail Addre6a city Statelzip Phone <br /> rtt:q , U <br /> Electrical Contractor MaiAddress City State/Zip ,�pha <br /> State License Number Con�tr{a' t Price of Work <br /> Proposed Use of Building Contact Pirson (Plan Reviewf <br /> squara Footage(if residential new construction, remodel or add(tiop) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: I r JS f W6 oeff n .2— d0orS <br /> &CX ard ess ry-\ �� c <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> t . <br /> I hereby certify that I have read and examined this application and know the same to be true and <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 focal law regulating construction or the Q <br /> performance of construction. That l am authorized by the owner of this property to perform the E C> Ian, <br /> 6`0 '7 <br /> work for which application is made and I comply with the State Contractors Law 18,27 RCw and <br /> 297fh <br /> MW r s <br /> Signature Date <br /> Rev/.SEP 3rWJ3 <br />