3211 BROADWAY ELECTRONIC CIGARETTES LLC 2017-01-17

To: E Page 2 of 2 2016-07-11 14:00:41 (GMT) 18884000383 From: Deborah Shields 071En- ECTRICAL PERMIT APICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 j (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:3211 BROADWAY BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX_MULTI-FAMILY-#OF UNITS: ✓ COMMERCIAL USE OF BUILDING: • ... ELECTRICAL APPI.I ATION INFO MATION CONTRACT PRICE OF WORK: $350 NUMBER OF DEVICES(if low voltage):2 FIRE ALARM? ❑YES / NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: ADDING TO EXISTING LOW VOLT SECURITY SYSTEM COAITACT INFORMATION . OWNER NAME: ELECTRONIC CIGARETTES LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3211 BROADWAY CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425-374-8310 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 c,TYBOTHELL STATE WA ZIP 98011 CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM CONTRACTOR LIC.#(REQUIRED):ADTLLL*881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED)O5509555 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR Y OTHER(Please Specify) JENNIFER COVELLO/AGENT CONTACT NAME: CONTACT PHONE:206-774-9499 JENNIFER COVELLO CONTACT EMAIL:JENNIFER@NWPERMIT.COM AGREEMENT.T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE Digitally signed by Jennifer PERMIT# Jennifer Covello Covell07/11 /2016 Date: 2°016.05.2217:12:03 Et 'e6() � '�') -07'00' l Owner/Authorized Agent Signature Date (Revised 10/1212015)