6928 EVERGREEN WAY STATE FARM 2017-01-17

To: E Page 2 of 2 2016-07-28 12:18:37 (GMT) 18884000383 From: Deborah Shields 4E77 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:6928 EVERGREEN WAY BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX MULTI-FAMILY-#OF UNITS: 7 ✓ COMI14ERCIAL USE OF BUILDING: t(00Ti.t10 ARPLIGATION 1NF00000IOM CONTRACT PRICE OF WORK: $250 NUMBER OF DEVICES(if low voltage):4 FIRE ALARM? ❑YES ✓ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: LOW VOLT SECURITY SYSTEM ,GONIA T INFOR.MATIEN OWNER NAME: STATE FARM TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET6928 EVERGREEN WAY CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425-374-8077 OWNER EMAIL: • CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 CITYBOTHELL 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)050955 PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ✓ 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 I have read and examined this application and know the seine 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 t am authorized by the owner of this property 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 . oO Digitally signed by Jennifer PERMIT# Jennifer Covello`''CDOVe110 07/28/2016 Date:2016.05.22 17:12:03 C C �O� ^of -0700' 1 Owner/Authorized Agent Signature Date (Revised 10/12/2015)