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To: E Page 1 of 2 2015-11-12 22:44:23(GMT) 18884000383 From: Deborah Shields <br /> ............ ............-.1-1..............---....... ..... ............. <br /> ELECTRICAL PERIN"11T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-2578810 - FAX 425-257-8857—vmweverettwa,org <br /> 1732 BROADWAY <br /> PROJECT ADDRESS <br /> AFFORDABLE INJURY ATTORNEYS 1732 BROADWAY EVERETT 98208 206-355-3546 <br /> Owner Mail Address city statetzip Phone <br /> AFFORDABLE INJURY ATTORNEYS 1732 BROADWAY EVERETT WA 98208206-355-3546 <br /> Tenant Mail Address City State/Zip Phone <br /> 11824 NORTHCREEK PIKWY N WA 98011 206.7 74-9499 <br /> ADT LLC #lo5 BOTHELL, <br /> Electrical -C,ontractor Mail Address City State/Zip Phone <br /> 1 ADTLLL*881 DO 050955 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Commercial 300 <br /> Proposed Use of Building Contract Price of Work <br /> JENNIFER COVELLO 206-774-9499 JENNIFER@NWPERMIT.COM <br /> Square Footage(if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 1 control/ 5 devices <br /> Number of devices(If low voltage) <br /> LOW VOLT SECURITY SYSTEM <br /> I Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and ex � 1'5 <br /> 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/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 pal <br /> 296.200 WAC. <br /> 0.:DN!on-JoAhktl v <br /> Jennifer Covell . 11/12/2015 <br /> 0=2018.08.00 12AiI70-07'00'o <br /> Signature Date <br /> REVISED 00,16W2014 <br />