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To: E Page 1 of 2 2016-06-01 12:20:46 (GMT) 18884000383 From: Deborah Shields <br /> ELECTRICAL PERMIT APPLICATION <br /> her,-�_ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.govlpermits <br /> PROJECTSITS IINFORMATION:;< <br /> PROJECT ADDRESS:406 SE EVERETT MALL WAY STE 102 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX) !MULTI-FAMILY-#OF UNITS: ✓ COMMERCIAL <br /> USE OF BUILDING: <br /> E k cAc ARoLoCATJON INFORMATIION' <br /> CONTRACT PRICE OF WORK: $160 <br /> NUMBER OF DEVICES (if low voltage):4 <br /> FIRE ALARM? ❑YES I NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> LOW VOLT SECURITY SYSTEM <br /> Ci�N'tl'ACT INFORMATION <br /> OWNER NAME: BUILT SOLUTIONS TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 406 SE EVERETT MALL WAY STE 102 <br /> ciTY EVERETT STATE WA ZiP 98208 <br /> OWNER PHONE:425-374-8473 OWNER EMAIL: <br /> CONTRACTOR NAME:ADT LLC <br /> CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 <br /> CITYBOTHELL STATE WA Z,P 98011 <br /> CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM <br /> CONTRACTOR LIC.#(REQUIRED):ADTLLL'881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED)050955 <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR 'OTHER(Please Specify) JENNIFER COVELLO/AGENT <br /> CONTACT NAME: CONTACT PHONE:206-774-9499 <br /> JENNIFER COVELLO CONTACT EMAIL:JENNIFER@NWPERMIT.COM <br /> AGREEMENT:T hereby certify that I have mad and examined this application and know the same to be true and correct, All provisions of laws and ordinances governing this <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 00 <br /> Digitally signed by Jennifer PERMIT# <br /> Jennifer Covellq`Daoty: 06/01 /2016 Date:2016.05.12 06:15:06 C R coo �i - 0 0( <br /> 07'00' C✓ o <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />