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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PEkMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />Z4102. Sc 141+y W 5- 0 <br />PROJECT ADDRESS <br />Owner Mail Address City StalelZip Phone <br />16W,4ne W . s5 Igo 7 Eya2eM*Hj.( WAS g2s-939s Fog I -- <br />Tenant Mail Address City State/Zip Phone <br />_ ADT 11824 North Creek Parkway North #105 Bothell, WA 98011 G� <br />- 5Z�f , <br />Electrical Contractor Mall Address city State/Zip Phone ta <br />ADTSES103205 �q0a - <br />State License Number Contract Price of Work <br />J�� AA- o S--yuz-�3 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Install low voltage alarm system <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby, certify that / have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance <br />or which applicareCon is made and I authorized <br />by <br />the State ContrhactorsspLaw 18 27 RCW and <br />296.200 WAC. <br />—i-�S gnalur�—-o..�>;a�ra p371! ti S <br />-- >P; 3-�� <br />