1807 BROADWAY A 2017-02-27 - Laserfiche WebLink

To: E Page 2 of 2 2016-09-08 04:44:33 (GMT) 18884000383 From: Deborah Shields ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITS INFORMAT Oi+f PROJECT ADDRESS:1807 BROADWAY STE A BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: :ELECTRIICAL.APPLICATION (INFORMATION CONTRACT PRICE OF WORK: $300 NUMBER OF DEVICES(if low voltage):4 FIRE ALARM? 0 YES / NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: LOW VOLT SECURITY SYSTEM CONTACT INFORMATION OWNER NAME: E DEVICE FIX TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1807 BROADWAY STE A CITY EVERETT STATE WA zip 98201 OWNER PHONE:425-314-7096 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 CITY BOTHELL STATE WA ZIP 98011 CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM CONTRACTOR LIC.#(REQUIRED):ADTLLL*881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED)055O9555 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Y OTHER(Please Specify) JENNIFER COVELLO/AGENT CONTACT NAME: CONTACT PHONE:206-774-9499 JENNIFER COVELLO CONTACT EMAIL:JENNIFER@NWPERMIT.COM AGREEMENT.T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE S . 00 Digitally signed by Jennifer PERMIT# Jennifer Covello`cOVe110 09/07/2016 E C(J9 - COZ Date:2016.05.22 17:12:03 -07'00' Owner/Authorized Agent Signature Date (Revised 10/12/2015)