Laserfiche WebLink
To 'age 2 of 2 2016-10-14 13:33:46(GMT) 18884000383 From: Deborah Shields <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION ..' .._.. ..; <br /> PROJECT ADDRESS:9220 EVERGREEN WAY <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.APPLICATI©N INFORM/ TIOhI <br /> CONTRACT PRICE OF WORK: $950 <br /> NUMBER OF DEVICES(if low voltage):1 CONTROLS 6 DEVICES <br /> FIRE ALARM? 0 YES ✓ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> LOW VOLT SECURITY SYSTEM <br /> - C;ONTACT INFORMATION <br /> OWNER NAME: GODFATHER PAWN TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET9220 EVERGREEN WAY <br /> CITY EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE:425-417-6963 OWNER EMAIL: <br /> CONTRACTOR NAME:ADT LLC <br /> CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 <br /> CITYBOTHELL 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.#(REQUIRED)050955 <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 t am authorized by the owner of this property 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..Date. o 10/14/2016 E i O <br /> .Date:2016.05.22 17:12:03 I <br /> -07'00' l <br /> OwnerlAuthorized Agent Signature Date (Revised 10/12/2015) <br />