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�o c � sm � ..r v �ui �-w.iv o� o� .�n rc3r„��r� �u��u.wou-�n:� r�o... o..�..,.� <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 o� `—a�� `� � <br /> C��.o� _l5� <br /> 11225 'i9th Ave SE Apt B102 <br /> PROJECT ADDRESS <br /> Artisian By Lake 11225 19th Ave SE EVERETT WA 98208 4z5-338-3434 <br /> Owner Mail Address City Slate/ZiD Phone <br /> Tenant Mail Address Gty State/Zip Phonc <br /> ADT LLC 11824 NORTHCREEK PKWY N gOTHELL, WA 98201 206-774-9499 <br /> Eleclrical Contrador tdail Address Cdy Stale/Zip Pnone <br /> F�DTLLL*881 DO 299.00 <br /> State License Number Contraci Pnce of Work <br /> Multifam jennifer@nwpermit.com <br /> Proposed Use of Building Contact Person (Plan Rewew) <br /> Square Footage Qf tesidential new construction, remodel or addition) <br /> 1 Control/ 3 Devices <br /> Number of devlces Qf lowvoltage) <br /> Descrip�ionofWorktoBeDone�. IntrUS�On A�arm Insta��at��n <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � . �� <br /> 1 huroby cortily(hal 1 havo rcad and oxanrinnd(his applicafion and know the same(o be(me anU <br /> correcG All pmvisions o/laws end oNinances goveming tbis typo o!wo�k will Ao complo(ed <br /> whethnr^peti(ed horain ornat The yranling o/a permil doos nof prasumo fo 9ive authorily(o PERMITN <br /> violafe or cancol lho provisions ol ony ofhor sfate orlocal law regulatiny conslnrclion ortho r � �O� —�C n <br /> perlonnance ol conslrucfion. 7haf I om aulhoriuzd by the ownei ol this p�operty fo pednnn Ihe t J `� <br /> work lor which�pplicafion is mado and 1 comply wifh!he Sfalc Confn.r,lors Law 18.27 RCW and � <br /> 296.200 WAC <br /> .v.,v.� .u.... <br /> ,lennifer Covello �'�"""•�""�'.",.'_.,�'.'.. 02/26/2014 <br /> �nNv� ani�.n4r <br /> +I���nQ•.a�n�qn�Z�) <br /> Pn JY�017101tU lTA' <br /> Signalure Dale <br /> RcVISEDIR(YU <br />