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9 0 <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—vmw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 9930 EVERGREEN WAY STE Z150 <br /> PROJECT ADDRESS <br /> THERAPEUTIC HEALTH SERVICE 9930 EVERGREEN WAY STEZ150 Everett WA,98204 4253475121 <br /> Owner Mail Address City State/Zip Phone <br /> THERAPEUTIC HEALTH SERVICE <br /> Tenant Mail Address City State/Zip Phone <br /> ADT LLC 11824 NORTHCREEK PKWY N BOTHELL, WA 98011 206-774-9499 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ADTLLL*881 DO $100 <br /> State License Number Contract Price of Work <br /> Commercial jennifer@nwpermit.com <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> ADD ON INSTALL: INTRUSION INSTALL: KEYPAD, PANEL, SENSORS (one control, two devices) <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 5 0. 0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l herebycertify that l have read and examined this application and know the same to be true and 3o Q , <br /> correct. All provisions of laws and ordinances governing this type of work will be completed D <br /> I `( <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <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 l comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> UyuIM vNrvJ trylrrrril.r uury.ra <br /> Jennifer Burgess ✓kNMll l�vifVr uiy vsu NO INVFsI YFHMII,uu NONIMYk11 <br /> rr,,arr.f..M,r,v.rrrwrr <br /> Uir.]013.0909 13.1 J 09 0)00 <br /> Signature Date <br />