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( <br />ELECTRICp►L PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA98201 �I`�Z�O <br />425-257-8810 - FAX 425-257-8857 — www.evere?twa.org ��Q �/ �066 <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />15 sw everett Mall Way <br />PROJECTAODRESS <br />EVERFTT PROJECT LLC same as project address EVERETT <br />Owner <br />Mail Address <br />Molina healthcare same as above <br />Tenant <br />Mall Address <br />Ciy <br />�ry <br />ADT SECURITY SER\�ICES 11824 N CREEK PKWY N#105 BOTH ELL <br />Electrical Contrador Mail Address <br />ADTSES103205 <br />State License Number <br />COMMERCIAL- OTHER RETAIL <br />Proposed Use of Building <br />Description of Work to Be Dcne: <br />ay <br />98204 425-402-3357 <br />StateJZip Phone <br />425-402-3356 <br />Slate/Zip Phone <br />WA 98011 360-945-2787 <br />State2ip Phone <br />$12,299.00 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />INSTALL LOW VOLTAGE ACCESS CONTROL SYSTEM - � Cv�o\ � lJ ��� � <br />NOTE: WIRING IN NON-DWEL�.IIIGS IS REQUIRED TO <br />BE I� RACEWAYS, MC OR AC CABLE. <br />CIYY OF EVERETT LOCAL SALES TAX (:ODE IS 3105 <br />I hereby certify that 1 have read and examfnetl thls applicat/on and know the same lo be frue and <br />ccrrect All p�ovisions ollaws and ordinances goveming this type of work wi/l be comp/eted <br />�vhether specdied herein or not The granling oI a permrt does not presume to give authonry fo <br />vrolate or cancel the provisions of any other state or local law �egulating consVucbon or the <br />per/ormance o�consvuM�on. That l am authorized by the owne� ol th�s property ro pe�lorm the <br />wak !o� which appl/catlon is made and I crompfp wifh the State Confractors Lew 18.27 RCW and <br />296.200 WAC. <br />.�` <br />-Signature ate � <br />FEE <br />��i7i�-U�9�P <br />