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To: E Page 1 of 3 2015-11-05 23:52:37 (GMT) 18884000383 From: Deborah Shields <br /> _._..... —-.,_... ---- .................. -----------—---- -----——----- ---- <br /> ELECTRICAL <br /> --ELECT ICAL 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 /> I <br /> I <br /> i <br /> I <br /> 9505 19TH AVE SE ( o <br /> PROJECT ADDRESS <br /> LANDER ROBINSON LABS 9505 19TH AVE SE EVERETT 98208 206-355-3546 <br /> I <br /> I <br /> Owner Mail Address City State/Zip Phone <br /> i <br /> LANDER ROBINSON LABS 9505 19TH AVE SE EVERETT WA 98208206-355-3546 <br /> Tenant Mail Address City State/Zip Phone <br /> ADT LLC 11824 NORTHCREEK PKWY N#105 g OTH E L L, WA 98011 206-7 74.9499 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ADTLLL*881 DO _0_50955 <br /> State license Number(required) City of Everett Business license Number(required) <br /> I <br /> Commercial 1200 <br /> I <br /> Proposed Use of Building Contract Price of Work <br /> JENNIFER COVELLO 206-774-9499 JENNIFERgNWPERMIT.COM <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/(Contact Number/Email <br /> i <br /> 2 control/ 10 devices <br /> Number of devices(if low voltage) <br /> Description of Work to Be Done: LOW VOLT SECURITY SYSTEM & CCTV SYSTEM <br /> i <br /> i <br /> FEE 6 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 d <br /> I l1 hereby certify that/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 worn 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 r O <br /> performance of construction, That/am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> DigBxry�gn°tl op Jenntcr C°odic <br /> Jennifer Covello'° 11 /05/2015 <br /> I °su:zo1s.ca.oc tz:<tac-m•oo• <br /> Signature Date <br /> I <br />