1515 112TH ST SE TEXACO 2017-03-13

To: E Page 2 of 2 2016-09-08 21:11:32 (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 { (E)everetteps©everettwa.gov I www.everettwagov/permits PROJECT:$.0011#000:4j164. PROJECT ADDRESS:1515 112TH ST SE 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: ELECTRICAL APPLICATION INFORMATIO!V CONTRACT PRICE OF WORK: $150 NUMBER OF DEVICES(if low voltage):4 FIRE ALARM? 0 YES / NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: LOW VOLT SECURITY SYSTEM .... OWNER NAME: SILVER LAKE TEXACO TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1515 112TH ST SE CITY EVERETT STATE WA ZIP 98208 OWNER PHONE:425-948-6116 OWNER EMAIL: CONTRACTOR NAME:ADT LLC CONTRACTOR ADDRESS: STREET 11824 NORTHCREEK PKWY N #105 CITY BOTHELL STATE WAZIP 9 = . CONTRACTOR PHONE:206-774-9499 CONTRACTOR EMAIL:JENNIFER@NWPERMIT.COM r7 CONTRACTOR LIC.#(REQUIRED):ADTLLL*881 DO CITY OF EVERETT BUSINESS LIC.#(REQ ED)050955 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR • 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 oflaws 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 Digitally signed by Jennifer PERMIT# Jennifer Covello"Datell2016.05.2217:12:03 09/08/2016 E I .oc ccE -07'00' Owner/Authorized Agent Signature Date (Revised 10/12/2015)