6624 EVERGREEN WAY BODY & MECHANIC 2017-01-17

To: E Page 1 of 2 2016-04-29 16:03:46 (GMT) 18884000383 From: Deborah Shields (01:7T tLECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT.SITE INFORh A'TION PROJECT ADDRESS:6624 EVERGREEN WAY BUILDING AREA(if residential, new construction, remodel,or addition) _SF BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX MULTI-FAMILY-#OF UNITS:___ _ V COMMERCIAL USE OF BUILDING:COMMERCIAL ELECTRICAL APPLIICATION INFORMATION CONTRACT PRICE OF WORK: $1400 NUMBER OF DEVICES (if low voltage):9 FIRE ALARM? ❑ YES V NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: LOW VOLT SECURITY SYSTEM AND CCTV SYSTEM CONTACT INFORM :TION. OWNER NAME: BODY AND MECHANIC TENANT NAME(If Commercial):BODY AND MECHANIC OWNER MAILING ADDRESS: sTM:CT6624 EVERGREEN WAY crry EVERETT SLATE WA r.zw 98203 OWNER PHONE:425-931-5432 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 CITY BOTHELL STALE_ WA ,,; 98011 CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM CONTRACTOR LIC.#(REQIIIRED):AD1 LI L'881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED)050955 UIRE.))050955 PRIMARY CONTACT: El OWNER 0 CONTRACTOR /bTHER(Please Specify) JENNIFER COVED Ot AGENT CONTACT NAME: CONTACT PHONE:206-774-9499 JENNIFER COVELLO CONTACT EMAIL: JENNIFER@NWPERMrr,cOM AGREEMENT:T hereby certify that I have read and eraatined tilts appficalkin and know the same to be true and correct. Ail provisions of laws and ordinances governing this type of work wilt be ctornplefed whether specified herein or riot. The granting of a permit does not presume to give autho»ly to violate or cancel the provisions of any other state or ifiCal law regulating construction or the Dcrfonnonc e of construction. That I era authorized by the owner of this proporty to perform tin:work for which application is made and f comply with the State Contractors Law 15.27 RCW and 296.200 WAC. _ City of Everett Official Use Only FEE I �/ 1l l �� PERMIT# Gigifally siyncri ny Jennifer Covello 6N rn Jener.(a Govelwperlo,.c ou, E _-0� s�a ' (` ,bbate- enniferr� 04/281201 0 1� � e ,`6�, I a,,w�>arrnit c:xr c �5 Owner/Authorized Agent Signature Date (Revised 10/12/2015)