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ELECTRICAL PE�M�T APPLICATIOt� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CrDAR STREET, EVERETT, WA 98201 <br /> d25-257-8810 - FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1124 SE Everett Mall Way <br /> PROJECTADDRESS <br /> Bank Of Arierica same as site address Everett WA / 98208 425-402-3357 <br /> Owner <br /> M11ail Address City Slate/Zip Phone <br /> Tenant <br /> Mail Address City Stale2ip Phone <br /> ADT SECURITY SERVICES WC. 11624 N CREEK PKWY N,SUITE a105 BOTHELL WA 98017 360-945-27R7 <br /> Electrical Contractor l.lail Address City State/Zip Phone <br /> ADTSES103205 1000.00 <br /> State License Number Contract Price of Work <br /> Commercial (BANK) William 360-945-2787 (Agent) <br /> Proposed Use ot Buildino Contact Person (Plan Review) <br /> Add one CCTV camera to ihe existing CCTV system. Drive Up teller Area <br /> Description of Work to Be Dcne: <br /> I;OTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heieb/certify that I hava read antl examined this application and hno�v the same to be t�ue and � �I I � _ D�� <br /> cenecG All prov�sions ollaws and ordinances governmg tliis rype of�vor��vill be completed � � � <br /> whether specdied herein or nof. The granling o/a permrt does not presume to give authority to v <br /> vrolate or cancel fha provisions of any other state or local la�v regulahng construction or(he <br /> performance of construction. That I am authorized b}�1he owner o/this property ro perlorm tbe <br /> work for�vhich application is made and I comply wifh the Stafe ConVactors Laei 18.27 RCW and <br /> 296200 WAC. <br /> D�gnallv+�9��"�I bY�'hllimn h411hull�n <br /> � William fVtillhollin °':��� „�����",",��°��°��,° ","�`��," 10 / 10 / 11 <br /> , ��.�ma,�-„����,�;,�,.,�:�,,,n,�o,,,.�,�,s <br /> De!u'.'911;:tl il 49:552h.0]'C.' <br /> Signature ale <br /> L__— __— <br />