3715 COLBY AVE STATE FARM 2017-02-27

To: E Page 2 of 2 2016-11-02 12:48:41 (GMT) 18884000383 From: Deborah Shields tLECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps©everettwa.gov I www.everettwa.gov/permits O ECT SITE INFORMATION PROJECT ADDRESS:3715 COLBY AVE 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: 1;L,ECTRICAL.A PLICATION INFORMATION CONTRACT PRICE OF WORK: $250 NUMBER OF DEVICES(if low voltage):1 control and 3 devices FIRE ALARM? 0 YES / NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: LOW VOLT SECURITY SYSTEM CONTACT 1NFORMATICN . OWNER NAME: STATE FARM TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3715 COLBY AVE CITY EVERETT- STATE WA ZIP 98204 OWNER PHONE:425-252-5121 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 CITYBOTHELL STATE WA ZIP 98011 CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENN I F ER@N WPERMIT.COM CONTRACTOR LIC.#(REQUIRED):ADTLLL*881 DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED)O55O9555 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR V 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 I 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE l� Digitally signed by Jennifer PERMIT# Jennifer Covello,DaCovei'e:20o 16.05.12 06:15:06 11/01 /2016 E�j l� ` _ c02- .. 07'00' Owner/Authorized Agent Signature Date (Revised 10/12/2015)