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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 /> 6200 23rd Drive West Suite#100 <br /> PROJECT ADDRESS <br /> Teague 6600 Merrill Creek Pkwy Everett WA 98203 <br /> Owner Mail Address City State/Zip Phone <br /> Dreamliner Gallery 6200 23rd Drive W. Ste #100 Everett WA 98203 <br /> Tenant Mail Address City State/Zip Phone <br /> Pride Electric 18133 NE 68th St. #D120 Redmond WA 98052 425-454-3665 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> PrideelO77DR $325.00 <br /> State License Number Contract Price of Work <br /> Office Chris Goad <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Install (2) 15A 120V switched receptacles for sleeping quarter lighting <br /> controls <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 2 z 5 <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 local law regulating construction or the -1 E (I, i ® �� <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> CL(, <br /> Signature Date <br /> REVISED 3/20/13 <br />