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To: E Page 1 of 2 2015-07-06 14:19:42 (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 /> li <br /> 11216 H1�j I I V V LA Y <br /> PROJECT ADDRESS <br /> Rancho Grande Market 11216 Highway 99 EVERETT 98204 425-355-9493 <br /> Owner Mail Address City State/Zip Phone <br /> Rancho Grande Market 11216 Highway 99 EVERETT WA 98204 425-355-9493 <br /> Tenant Mail Address City State/Zip Phone <br /> ADT LLC 11824 NORTHCREEK PKWY N#105 BOTHELL, 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) <br /> I Commercial 357.00 <br /> i i <br /> Proposed Use of Building Contract Price of Work <br /> JENNIFER COVELLO 206-774-9499 JENNIFER9NWPERMIT.COM <br /> Square Footage (if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> 0 Control/3 devices <br /> I Number of demes (if low voltage) <br /> Adding to existing security system <br /> I Description of Work to Be Done: <br /> FEE <br /> 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> hereby certify that I have read and examined this application and know the same to be true and <br /> correct. Ail 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 B I C^ <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1)W (o,G- .-N.Ith 11C P.—ft <br /> Jennifer Covello.- un7/06/2015 <br /> Das:201u.0520 ta.11:0u-07'0.7 <br /> Signature Date <br /> R_VISED on"06112014 <br />