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To: E Page 1 of 1 2016-08-09 18:39:52(GMT) 18884000383 From: Deborah Shields <br /> 44c77- ECTR1CAL PERMIT AP LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMAI"ION <br /> PROJECT ADDRESS;2024 BROADWAY <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE SFR-DETACHED SFR-ATTACHED DUPLEX MULTI-FAMILY-#OF UNITS: ✓ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFOt MATION <br /> CONTRACT PRICE OF WORK: $650 <br /> NUMBER OF DEVICES(if low voltage):6 <br /> FIRE ALARM? ❑ YES / NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> LOW VOLT SECURITY SYSTEM <br /> CONTACT INFORMATION . <br /> OWNER NAME: MOTORCYCLES GOODIES TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET2024 BROADWAY <br /> CITY EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE:206-890-9961 OWNER EMAIL: <br /> CONTRACTOR NAME:ADT LLC <br /> CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N#105 <br /> C,TYBOTHELL STATE WA zip 98011 <br /> CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM <br /> CONTRACTOR LIC.#(REQUIRED):ADTLLL`881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIREo)O5O9555 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) JENNIFER COVELLO/AGENT <br /> CONTACT NAME: CONTACT PHONE:206-774-9499 <br /> JENNIFER COVELLO CONTACT EMAIL:JENNIFER@NWPERMIT.COM <br /> AGREEMENT;T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> Digitally signed by Jennifer PERMIT# <br /> Jennifer Covello, <br /> ateIl2016.05.2217:12:03 08/09/2016 <br /> -07'00' EE 0 �� <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />