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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32D0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org 5-9--l3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1510 SE EVERETT MALL WAY #C <br />PROJECTAD�RESS <br />PERFECT SMILES DENTISTRY 1510 SE EVERETT MALL WAY ttC <br />owner <br />Meil Address <br />Ciry <br />PERFECT SMILES DENTISTRY 15'10 SE EVERETT MALL WAY #C <br />Tenant <br />Mail Address <br />City <br />ADT SECURITY SERVICES INC. 11824 N CREEK PKWY N, SUITE Jt105 <br />Electrical ConVactor Mail Address ���Y <br />ADTLLL*881 DO <br />State License Number <br />Commercial - Medical Dental <br />Proposed Use of Building <br />Everett <br />Everett <br />BOTHELL <br />� � �s 0.�Z <br />WA/98203 <br />Slele2ip <br />WA/98203 <br />State/Zip <br />WA 98011 <br />Slete2ip <br />425-513-2222 <br />Phone <br />425-513-2222 <br />Phone <br />360-9a5-2787 <br />Phone <br />$2��.�� <br />Contract Price of Work <br />William 360-945-2787 (Agent) <br />Contact Person (Plan Review) <br />INSTALLING A SAFEWATCH 3000 AND REPLACING RECEIVEF - Security low volt <br />Description of Work lo Be Done: <br />NOTE: WIRING 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 />l hereby certify that l have read and examined this application and know the same to be true and <br />correct A/l proviswns ollaws and ordinances govemmg this type ofwork willbe completed <br />�vhetherspecdied herein or not. 7he granting o/ a permrt does not presume to give authonty to <br />violate or cancel the provisAns of any other state or local law regula6ng constrochon or the <br />peiformance of construction. That / am authorized by ihe owner ot ffiis property to perlorm the <br />�vork for which application is made and I comp.'y �vith the State ConVactors Law 1827 RCW and <br />296.200 WAC. <br />on��+��r+�:meJ Lv �Nli.m nflihoin <br />WilliamMillhollin°"`m;�''H,�,amF',;.""°-�om'�m�s 05/08/2013 <br />��,m, <br />Ve�e:I0110B.09U1'31:35�0>'OJ' <br />igneWre ale <br />FEE <br />��0-UU <br />[ c 3C��5— �S� <br />