5108 EVERGREEN WAY EVERETT SMOKE SHOP 2016-10-20

To: E Page 1 of 2 2016-04-19 04:13:19 (GMT) 18884000383 From: Deborah Shields RECTRICAL PERMIT AP%ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT; WA 98201 (P) 425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits TPR � � IT 1JFRANo PROJECT ADDRESS:5108 EVERGREEN WAY STE 1A BUILDING AREA(if residential,new construction, remodel,or addition)_____Y SF ILDING TYPE SFR-DETAC,;HFD FR-ATTACHED JUPLEX MtJLTI-FAMILY-#OF UPJ ITS:_,,__, ✓ COMMERCIAL. ru—s— OI BUILDING:COMMERCIAL LECTRICAL:APPLI.GATIQN fNQRMi4'iC'�QN.' CONTRACT PRICE OF WORK: $3200 NUMBER OF DEVICES (if low voltage):19 FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: CCTV SYSTEM CCl1+ITACT INN*+r.FC1111 #TiC)N OWNER NAME: EVERETT SMOKE SHOP TENANT NAME(If Commercial):EVERETT SMOKE SHOP OWNER MAILING ADDRESS: STRF-,T 5108 EVERGREEN WAY STE 1A c,T,. EVERETT STATEWA"' ` zr, 98203 OWNER PHONE:206-354-8776 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: sTREET 11824 NORTHCREEK PKWY N #105 CITY BOTHELL STATE WA z1f, 98011 CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM CONTRACTOR LIC.#(R F.QUIRFD):AD1*LI_L'881 DO CITY OF EVERETT BUSINESS LIC.#(REntJIRFD)050955 PRIMARYCONTACT: ❑OWNER ❑CONTRACTOR V THE R (Please Specify)-JENNIFER COVELLOr AGENT ----------- ._,...__ CONTACT NAME: CONTACT PHONE:206-774-9499 JENNIFER CC}VELLC3 CONTACT EMAIL:JENNIFER@NWPERMIT.COM AGREEAJENT:T hereby certify that 1 have read and e.xatrnned this appiwation and know the same to be true and correcL N!provisions of laws:and ordinances governing this type,of w:.r'k wit!Ge caarnplated whether specified herein or rrot. The granting of a permit does not presume to give authority to violate or cannel the provisions of any other state or :caR;w rr>gu!uti y construction or the pCr ormar,<x>of constarction. That f am autharizcd by the ownor orthis prapCrty to perforrn the work for which application is mads and; C0nrpiy with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official U,se Only FEE } r a� Digitally signers byJerxvter Ccvelio PERMIT _DN cn Jennifer Covello,o,ou, ek a y x amgll Jennder2Lnwpennd.crxn,c-US 04/18/2016 Cj./ O Date.2016!)3 . .151a2L'.•ne 07'06' C I�/O ll Owner/Authorized Agent Signature Dale iRevised 10/12/2015)