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11-01-16; 03: 45PM; From: Evergreen Security Inc. To:4252578857 ; 4253538934 # 4/ 4 <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 /> 3458 3�rst unve 0�( O - -t rSC� �� \ SS <br /> PROJECT ADDRESS <br /> Polygon Homes 11624 S.E. 5th Street, Suite#100, Bellevue WA 98005 425-586-7700 <br /> Owner Mail Address City State/Zip Phone <br /> Polygon Homes- Model Home-Lot#158 <br /> Tenant Mall Address City State/Zip Phone <br /> Evergreen Security 8115 Broadway#101 Everett WA 98203 425-348-3850 <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> EVERGSI112L2 039160 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Commercial $2,187.00 <br /> Proposed Use of Building Contract Price of Work <br /> Sarah Murray <br /> mat-pup 425-348-3850 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 3_Hardwired <br /> sarahm@evergreensecurity.com <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Lsy+y volts e_security system_1 hardwired control panel w/tel(communicator <br /> 1 hardwired keypad._9 wireless contacts, 2 wireless motions & 1 hardwired siren. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 / <br /> performance of construction. That I am authorized by the owner of this property to perform the E \. 1 „ \ ' — 64�� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and `' <br /> 296,200WAC. <br /> SeceallJ MI�IYYaGJ 11/1/2016 <br /> Signature Date <br /> REVISED 08/06/2014 <br />