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• • <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.gov <br /> 12728 Bothell-Everett Hwy, Everett, WA 98208 <br /> PROJECT ADDRESS <br /> �OwA kt<_se- <br /> Mayemura Optical - 12728 Ro eH-Evereft-Hwy;Everett, WA 98208 <br /> Owner Mail Address City State/Zip Phone <br /> Mayemura Optical - 12728 Bothell-Everett Hwy., Everett, WA 98208 <br /> Tenant Mail Address City State/Zip Phone <br /> D. K Systems, Inc. -PO Box 886, Burlington, WA 98233-360-755-1555/John 360-770-5409/Darron 360-770-0950 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> DKSYSI"987M6 0 4 oq 5o3 <br /> State License Number(required) f-Ever tt Business License Number(required) <br /> Business <br /> Proposed Use of Building Contrarice of Work <br /> John Bateman -360-770-5409 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> johnb@dksystemsinc.com -or- <br /> 1 -T-Stat- Low Voltage tami@dksystemsinc.com <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: 1 -T-Stat and 1 - Exhaust Fan <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 _S 0 <br /> l 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 local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the t 111 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 08/22/2016 <br /> ignature Date <br /> REVISED 08/06/2014 <br />