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ELEGTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vnr,�r�.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3019 W Marine View Dr <br />PROJECT ADDRESS <br />NESS JASON R <br />OK71^f <br />PO BOX 1246, <br />Mail Address <br />Everett WA, 98206 <br />Ci�y State/ZiP Phone <br />Telmes Broadband 3019 W Marine View Dr, Everett <br />Tenant <br />ADT LLC <br />Mail Address <br />�ry <br />11824 NORTHCRE[K PKWY N BOTH ELL, <br />Eleclncal Contractor Mail 4ddress <br />ADTLLL*881 DO <br />S4ite license Nwnber <br />Small Business <br />Proposed Use af Building <br />Description of Work to Be Done: <br />Install low voltage security system <br />Qty <br />WA, 98201 4252523415 <br />SlatelZip Phone <br />WA 98011 <br />Stale2ip <br />$528.00 <br />Contra�t Price ol Worh <br />za�-��a-sass <br />��� <br />jennifer@nwpermit.com <br />Contact Person (Plan Review) <br />PdOTE �NIRING IN IdOIJ-DWELLIIJGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OF AC CABLE. �r��� <br />J�-� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRrlv that 1 have read and e�amined this applicafron and Fnow the same io be irue antl `% I� f 1 - I � j�% <br />carect. All piovi:ions ollaws and ordmances gove�ning this type o/ �vak �vill be complefey ti l� `-�"C5 <br />�vhether specdietl herein or not. The granting ol a permR does not resume 7o give authorGy to <br />wolate or cancel the prowsions o/ any otfier state or localla�v reguPting construction or tbe <br />p�fo�mance ol constructron That 1 am authori,ed by the o�vner ol this prope�ty to perform the <br />wah lor �vhich app6catron �s matle and I comp�y wrth the State Con�actors La�v 18 2i RCl4� antl <br />296.200 N�.AC. <br />,�_�..�..:,......�.. <br />Jennifer Burgess ` ...'':�-=::" �'" . "."" 11/20/2012 <br />ignature ,�... ..,.,• .•, ate <br />