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ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � ��� ��3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—vnnM✓.everettv✓a.org �-�3a � '��7 <br /> APPLICATIONS ARE ACCEPTED FROhi 8 AM TO 4 PM <br /> 11225 19t� Ave SE Apt #B102 <br /> PROJECTADDRESS <br /> Artesia by the Lahe 11225 19th Ave SE F_verett WA, 98204 �I25-338-3434 <br /> Owner Mail Address CiN State/Zip Phone <br /> Tenan[ Mail Address Qry StamJZip Phone <br /> ADTLLC 11824NORTHCREEI<PKWYN BOTHELL, WA98011 206-77d-9499 <br /> Electrical Contrador Mail Address Ciry State2ip Phone <br /> ADTLLL*881 DO $399.00 <br /> State License IJu�nber Contract Price of Work <br /> Multi-Fam jennifer@nwpermit.com <br /> Proposed Use of Building Contact Person (Flan Review) <br /> Description of Work to Be Cone� <br /> Intrusion Alarm Installation, One control, Nine Devices <br /> fdGTF: WIRING W NON-DWELLIf1GS IS REQUIRED TO FEE <br /> BE IM RACEWAYS, IJIC OR AC CABLE. � <br /> L��� . � �� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certify that I have reatl and eramined this application and Fno�v the same to be true a�;d j� � 7��,'� _ ! L,� `� <br /> comect All provisions ullaws and ordinances goveming fhis fype oI work �vill be completed � , � <br /> rih,ether specrlied herein or noL The g�anting ot a permn does not resume fo gNe authortty to <br /> vio,'ate or cancel the provisiens ol any other state or localla�v reguPting construction or tne <br /> perloimance ol const�udion. That I am authorized b}�the owner ol this properry to perform tne <br /> wa�F(or�vhich application is matle antl I compty�vith the State Contractors Latv 1827 RCW antl <br /> 29G200 WAC <br /> Jennifer Burgess ..,, , ,,, •�- "'�""" 0731/2013 <br /> bignature ate <br />