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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERIVIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (( �g�)� <br /> �J�" �( <br /> �lI o�f—�� � <br /> � EVERGREEN WAY <br /> PROJECTADDRESS <br /> LIBERTY INCOME TAX(Taxpayer) 8552 EVERGREEN WAY EVERETT WA /98208 425-348-9194 <br /> Owner Mail Address City SleleRip Phone <br /> N/A . <br /> Tenant Meil Address City Stete2lp Phone <br /> ADT SECURITY SERVICES INC. 11824 N CREEK PKWY N,SUITE A705 BOTHELL 'NA 98071 360-94''r2767 <br /> Electdcal Contractor Meil Address Ciry Stele2ip Phon� <br /> ADTSES 103205 $200 <br /> State License Number Contract Price of Work <br /> 659 Other Professional Services NEC William Millhollin 360-945-2787 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> oes«;P,;o�ofWo,k�oeeoo�e: ADD TO EXISTING SECURITY SYSTEM <br /> Tn _l l�di n� "I DeVic _ _ <br /> IJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certity that I have read antl examined thls application and know the same to be Vue antl <br /> carect. All provisrons of laws and ortlinantes govemmg ihis type olwork wi/l be completed �'i 1l r�� ���� <br /> whether specdretl herein or not The granting oI a permrt does not presume to give authonry to 1_ l� \ �� <br /> violate or cancel the provisans of any other state or local law regula6�ng consVucGon or the <br /> peNormance ol consVuction. That I am autharzetl by the owner ol this p�operry to peAorm the <br /> �vork fer which appin;ation is made and I comply�v4h Ihe State Conhactors La�v 78.27 RCW antl <br /> 296.200 WAC. <br /> pi�ully vqrcd L•y�NlLeinA4111u1Ln <br /> WilliamMillhollin ��';m';�'-»"�,"�"°;��:'°�,""�5 04 / 07 /2011 <br /> �.,�:,��n,���..��:�,�� <br /> �Ignature ale <br />