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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—NnNw.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7815 Evergreen Way #1 <br />PROJECT ADDRESS <br />Evergreen Asian Market Same as site <br />Owner <br />Mail Address <br />ciy <br />SlateJZip <br />4� i3/iz <br />E-%"7,4�'-�" f <br />Phone <br />Evergreen Asian Market Same as site Everett, WA 98208 4252657900 <br />Tenant 1�1ai1 Address Glty StateJZip Phone <br />ADT <br />Electrical Contrador <br />11824NORTHCREEKPKWYN BOTHELL� <br />ADTSES1032U5 <br />S4ite License Number <br />commercial <br />Propased Use of Bullding <br />Description of Work to Be Done: <br />Mail Address <br />Install low voltage security system <br />NOTE: V�iIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WA 98011 206-774-9499 <br />qty StalelLip Phone <br />$674.00 <br />Contract Price of Work <br />jennifer@nwpermit.com <br />Contact Person (Plan Reviev� <br />FEE <br />50`� <br />I hereby certily that / have �ead and exam/ned th/s appllcaffon and know the same to be true and C( Z_Qj 1�O� � <br />carecL All provlsions ollaws and ortlinances governing thls type of work will be completed —1 <br />whether specA�ed here/n or not The granting ol a permil does not presume to give authorrty to <br />v/o/ate o� cancel the provis/ons ol any other sfate o� local law �egulating construction or the <br />per(ormance o1 construdron. That l am authorized by fhe o�mer oI thls properry to per/o�m the <br />tvcrk for which application is made and I compy wlth the State ConVactors Law 18.27 RCW and <br />296.200 WAC. <br />�. � `Gk' � 7�...�....�. <br />Jennifer Burgess �:�, w�,;;;;;,o� �':'•'�.�w.'""" 04/12/2012 <br />ignature ate <br />