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ELECTRICAL PERMIT ARPLI'CATION <br /> CITY OF EVERETT PERMIT S�RVICES �_���i3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—NnnM�.everettwa.org ��3D� -1 y3 <br /> APPLICP.TIONS ARE: ACCEPTED FROM 8 AM TO 4 {'M <br /> 11225 19th Ave SE <br /> PROJECT ADDRESS <br /> Artesia by the Lake 11225 19th Ave SE Everett WA, 98204 425-338-3434 <br /> Owner Mail Address City StatelZip Phone <br /> Tenant MailAddress Qry StatdZip Phonc <br /> ADT LLC 1?82A NORTHCREEK PKWY N BOTHELL, WA 98011 ZC6-774-9499 <br /> Electrical Contractor Mail Address Ciry State/Zip Phone <br /> ADTLLL�`881 DO $307.00 <br /> State License Idumber Contract Price of Work <br /> Sm Business jennifer@nwpermit.com <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Workto Be Done: <br /> Addiny FIVE Devices tv Existiny Intrusion Alarm Main Office <br /> ��IOTE WIRING W NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE __ <br /> �� � � � <br /> CITY OF EVERETT LOCAL SALES T.`X CODE IS 3105 <br /> 1 hereby certdy fhat/l�ave read and examined this applicaticn antl know(he same to be 7ue antl �. ' 1���.�� ._ I ��+ ,_�, <br /> cenect. All p�ovisions ol/atvs and ordinances govemmg this type o(work aill be completed � <br /> �nhether specilied herein or not. The granting o!a permii tloes not presume to give a ufhorly ro <br /> v�elate or cancel the provisions o/any other state or localla�v regulating construct�on or!he <br /> per(ormance otconstrudion. That I am aufhorized by the o�vner of this preperry to per!orm the <br /> �vah!or whrch application is made and I comply�vith the State ConLactors Law 18.2i RCW antl <br /> 290 200 WAC. <br /> JenniferBurgess „_. ,,a,, „ , � ,�. "` "' ' 0730/2013 <br /> — ignature ate <br />