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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—vnnv�.everettwa.org C�3D�_Oc,t/ <br />�r <br />RPPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br />3322 52ND PL W <br />PROJECT ADORESS <br />BRADLEY LARSSEN 3322 52ND PL W <br />Ohner <br />tdad AdOress <br />BRADLEYLARSSEN <br />� enant S1ad Acdress <br />Everett <br />Ciry <br />Q�. <br />ADT LLC 11824 NORTHCREEK PKWY N gOTHELL, <br />Electncai ConiraRor M1:ail Address <br />ADTLLL"`881 DO <br />Sbte License NumLer <br />111 Single Family Residence Detached <br />Proposed Use of Butldin9 <br />Descnption of Work to Be pone <br />INTRUSION INSTALL-FANEL,AND CELL UNIT <br />IVOTE 4VIRI�lG Ih1 ��ION-GVJELLItJGS IS REQUIP.ED TO <br />BE I�l RACEWAYS, 1IC OR AC C/�Eil F. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�iy <br />WA,98203 <br />State2�p <br />StatelL�D <br />WA 98011 <br />State2ip <br />$300.00 <br />Con�ract Price oi Work <br />_lb-i <br />2069632815 <br />Phone <br />Phone <br />2o6a�n-sass <br />Phme <br />jennifer@nwpermit.com <br />Contact Person (Plan Review) <br />I nereDy certAy that I have read antl erammetl this applrcatwn and hno�v the same to be Vue ond <br />carect All piov�sions ollaws antl oidinances goveirong this rype oI worh �vdl Oe comple�etl <br />whefher specdied herem or not. The granting ol a permR tices not presume ro 9roe au�ho�,ry t� <br />violate oi cancel the provisrons ol any ofher st3fe or local law iegu/abng consbucnon or tne <br />paformance ol consvuC,ion 7hat I am autnoir.ec�?Y fhe o:mer of this properry tnperlorm fhe <br />wak !o� wh�ch applrcat�on s macle and I mmpry wi:r,'L^e State Contractors Law 16 27 RCW and <br />:. Sr; J00 WAC. <br />� �,,. �. �,� .,: , <br />.lamieAlanzo= °��:�:-�-m°������ �;,'15/2013 <br />1'L91'IM1i fIJ`]Ju` <br />` ignaturc � '��� --rt''=ts <br />FEE <br />Gj0 �06 <br />� �o�- ��Y <br />