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To: E Page 2 of 3 2016-01-27 21:33:53 (GMT) 18884000383 From: Deborah Shields <br />���I 1 ��� � � � 3 R��4.r► �� <br />li! 1 1�J� ��i���� f P�1"'5��� a7��Yllo�� <br />32a0 CED�iR STREET, EVERETT, WA 9820�i <br />425-257-88i 0- F,�X 425-257-�8�7 -- G�vww.everettv�ra.ory <br />��zo �aa�rH �� sE <br />PR(3.JECT ADaFiESS <br />SIL��ERLAKE FAhq!LY DENTiSTRY ��2O ! VO i H �� J� E V��ET� <br />OWneY P�ail Addres5 City <br />SILVERLAKE FAM(LY DEN1"ISl'RY � 820 14QTH PL SE E�{E ��T� <br />Ten�nt Mai! f�ddress City <br />��� ��� 11824NC1RTHCREEKI'K'NYNtl105 �������� <br />ElectriCa! ContraCtor Mail Address <br />!'�l���L..��L.JV � QlJ <br />�taFe Lic�ms� Nurr�her {raqi.�ir�d) <br />�:O i"7"t CY1 E: �'C I c� � <br />Propos�d Use of Bi�ildinu <br />Syuare Footage (Ii rasidential new construcliorr, remodel ar additionj <br />1 Control/ 7 devices <br />Number of devices (If iow volkage <br />City <br />V V!'1 .,7C.J�lJ{.? a25-:i37-'l_40� <br />Stete/Zip Phone <br />WA 982U8 425-337-?4C�0 <br />State/Zip phone <br />1lVA 98C3 `11 ���_„4_��G<, <br />. _.._____.�..___...______.__.____.. __._ <br />State2ip Phone <br />V�V��� <br />Giiy �f EvErett Fu�iness Lic�._..____._..._....._._..__.__ <br />� � n:SF N�n�ber (required} <br />650 <br />Contract Price of Work <br />.��r�rair�:� c:ovF��o zo� ,,4_a��s.�Eti�virr.p;a!v��e:>F.�^.�ir.r.ar.� <br />Contac± Person?Cantact Number?Emai) <br />n;;,��r;�t�p�, ��Wo�ktp �� oo��: LOV1l VOLT SECURITY SYST�M <br />CITY OF EVERETT �,CICAL SA�ES TAX CORE 15 3iQa <br />1,here�iy cer�ify thaf 1 have read �nd examined this a�Zpiication and know t/�e satne to �e true �nd <br />corr•er.t. R!! provisions of laws and ordinances governiny this type r�f work wi1! he compleied <br />whefher specifred herein ar' not, Ttte g�ritir�g of a�en�rit does not pr`esurr�e to give authority 10 <br />violate or cance( fhe prov;sions of any othersfate or tocat law regulating constnactir�n or fi��e <br />pE>!fa mance of construction. That 1 am authorrzed by fhe owner vf thrs prc�per:y ta perform th� <br />wroric far dvhrch apr�lrcatiai is rrtade a,nd ! comp(y with tlle Sfate Corifractors Law '8.27 F�CW anJ <br />296.200 WAC. <br />Jennifer Coveilo' �' �y' .. K n` p'°�, ;�.;�� Q �����2(.� ��'j <br />e o or�cs.ocv.�i:,-crw <br />Siynature pap� <br />re✓�stn oeinr✓2;:; ��i <br />FEE <br />PERMIT# <br />E � ���� - a��- <br />