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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wvwi.everettwa.org <br /> APPLICATIONS ARE ACCEP?ED FROM 8 AM TO 4 PM <br /> 10633 Evergreen Way Everett <br /> PROJECT ADDRESS <br /> P�9��atarovo�ks��,a9o� wc. SAME AS SITE A25-3d8-3141 <br /> Owner Mail Address Ciry State/Zip Phone <br /> SAME AS SITE <br /> Tenant <br /> Matl Address Qry State/Zip Phone <br /> ADT 11824 NORTHCR[EK PKWY N gOTH ELL, WA 98011 206-774-94°9 <br /> Electrical Contractor 61ai1 Address Qry State2ip Phme <br /> ADTSES103205 $3000.00 <br /> State License IJumber Contract Price of WorY, <br /> commercial jennifer@nwpermit.com <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> Reactivation of the existing Security System with the addition of two Key Pads and one Power Supply <br /> hIGTE WIRING IPI ��ION-DWELLIIJGS IS REQUIP.ED TO FEE <br /> BE W RACEWAYS, IJ1C OR AC CABLE. �O Oc'� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that I have reatl and examined ihis applicafion and Fnov�the same to be true and � �� I�) � I DO <br /> carecL All provisions o//a�vs and ordinances govermng this type ol work u�iU be completetl ` <br /> �vhether specified herein or noe The grenting of a permrt does not res�me to gr✓e aurhorrty to <br /> violate er cancel the provisions ol any ofher siate or local/a�v�eguPting consVuct�on or the <br /> perlormance of construction. That I am authori:etl by the o�vner ol this p�operry to perform the <br /> �vak for which application �s made and I comply�vifh �ne State Conhactors Law 782i RCW antl <br /> 296200 INAC <br /> Jennifer Burgess .. , � , � �� � "�""' 12/15/2011 <br /> ignature ate <br />