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ELECTMCAL PERNT APPUGAT110N <br />crry OF EVERETTPERIWIT SERVICES' <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.gov <br />5129 Hilltop Rd. <br />PROJECT ADDRESS <br />HCR LLC 970 5th Ave NW Ste 3 Issaquah WA 98027 <br />Owner Mail Address city State/Zip Phone <br />Forest View Transitional Health 5129 Hilltop Rd Everett WA 98203 <br />Tenant Mail Address City State/Zip Phone <br />Guardian Security Systems 1501 Kentucky St Bellingham WA 98229 360.647.0110 <br />Electrical Contractor Mail Address city State/Zip Phone <br />GUARDSS233K5 <br />State License Number (required) City of Everett Business License Number (required) <br />Health Facility $1,500.00 <br />Proposed Use of Building Contract Price of Work <br />250 Anthony Medawar- 360.440.5518. amedawar@guardiansecud <br />Square Footage (if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />1 <br />Number of devices (If low voltage) <br />Description of Work to Be Done: Provide and Install an AES Radio for the purpose of communication for the Fire Alarm. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 -7 <br />. <:Z - <br />hereby certify that / 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 local law regulating construction or the <br />performance of construction. That/ am authorized by the owner of this property to perform the E <br />work for which application is made and comply with the State Contractors Law 18.27 RCW and <br />216.21 WA, <br />04 November 2015 <br />Signature Date <br />REVISED 0810612014 <br />Y.Com <br />