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To: E Page Z��f :3 LO'1�1-O�-G4'1G'OG:<2 (GMT) 'IFfFiF340003CiJ F-rom: Oebr�ral� _�1-�ielGs <br />� <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 />3121 Broadway <br />PROJECT ADDRESS <br />Superbowl Pho <br />Owner <br />Tenant <br />ADT LLC <br />3121 Broadway EVERETT 98201 206-658-3878 <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />11824 NORTHCREEK PKWY N gpTHELL, WA 98201 206-774-9499 <br />Electrical Contractor Mail Address <br />ADTLLL'�881 DO <br />State License Number <br />Commercial <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />1 control/ 5 devices <br />Number of devices (If lowvoltage) <br />City State/Zip Phone <br />$1224.00 <br />Contract Price of Work <br />jen nifer@nwperm it. com <br />Contact Person (Plan Review) <br />Description ofWorkto Be oone: Intrusion Alarm Installation <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certify ihat I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governrng this type of work wi!/ be completed <br />whether specified herein or not. The granting of a perrnit does not presume to give authorify to <br />violate or cancel the prnvisions of any ofher staie or loca/ law regulating construction or ihe <br />performance of construcfion. That I am authorized by the owner of this property to peiform tfre <br />work for which applrcation is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />: Olgilony ai;l�ea by Jemrtar co,eilo <br />J e n n i f e r Cov e I I o' �� ��_��M�k, �o.e��o o.No,��,�e=� �e,�,�� �n� <br />ou=Re�ional Ac[ounlNl�n�y�er. <br />»�r-ic.v�ire���n�.00«mn.mm, c=us <br />� Date�2b1G�1.2� IUaoAG-00'VO' <br />Signature <br />REVISED 3/20/13 <br />01 /23/2014 <br />FEE <br />�, C�' <br />�, j�� , <br />PERMIT# <br />E i�����`-���-�� <br />