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To: E Page 1 of 1 2015-06-02 20:28:20(GMT) 18884000383 From: Deborah Shields <br /> .___ <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 /> 4821 Evergreen Way <br /> PROJECT ADDRESS <br /> Waterside Group 4821 Evergreen Way EVERETT WA 98203 425-252-2220 <br /> Owner Mail Address City State/Zip Phone <br /> Waterside Group 4821 Evergreen Way EVERETT WA 98203 425-252-2220 <br /> Tenant Mail Address City State/Zip Phone <br /> ADT LLC 11824 NORTHCREEK PKWY N#105 BOTH E L L, WA 98011 206-7 74-9499 <br /> Electrical Contractor Mail Address City state/Zip Phone <br /> ADTLLL*881 DO 050955 <br /> State License Number(required) City of Everett Business License Number(required) I - <br /> ' Commercial $281 .00 <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 install <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 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 L3/ 5 VG - 002, <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,. '::: no°Oy JonnH°r coo°iro 06/2/2015 <br /> Jennifer Covello'°"�°^"°^^a°r°°�°N°,°.N°�^y°1:�p°rmw <br /> In°,Au.Cn1d I-}:nnN°rt��mvperMl.c°m,°-U5 <br /> °.2016.06.02 12:20:22-07'00' <br /> Signature Date <br /> REVISED 00;08,201e <br />