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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PCR�IIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – wuw✓.everettv✓a.org )— I�– �3 <br />5314 33rd Ave W <br />PROJECT ADDRESS <br />Lisa Faller <br />CHmer <br />Tenant <br />ADT LLC <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5314 33rd Ave W Everett, WA 98203 <br />Mad Adtlress Gty State/Zip <br />Mail �tltlress Gry StateJLp <br />11824 NORTHCREEK PKWY N gOTHELL, WA 9b011 <br />Electucal Contractor Mail Adtlress <br />ADTLLL"`881 DO <br />Slate License Wumber <br />Residential <br />Proposed Use ot BuAdmg <br />Oescnption of VVork �o Be Done� <br />Insiail low voltage security system <br />IdOT6 WIRING IN f�ION•pWELLII�IGS IS REQUIRED TO <br />f3E IN RAC[VJAYS, InC CR AC �l�I�LF, <br />CITY OF EVFRETT LOCAL SALES TAX CODE IS 3:05 <br />C��Y StatelZip <br />$829.00 <br />C- ��1�09z <br />Conlract Price of Work <br />425-345-3764 <br />Phonc <br />Phone <br />206-774-9499 <br />Phone <br />jennifer@nwpermit.�;om <br />Contact Person (Plan Review) <br />FEF i <br />��C� DO —� <br />l hereby ceiLly flra! I Y,ave read m�U examired th�: apphcation and know fhe same fo be l�ue and <br />carecl All piovis�ons ollows and ordinances qoveinuig thrs type oI work w�il be completed r �� O�- O l Z <br />whetlrer specdied he�e�n or not The grannng ol a peimrt tloes not resume ro yive authora}� to t- <br />viu'are or cance/ the provurons ol any olhcr state or ioca� lavr ieguPting constructron or fhe <br />pc�loinrance o( cons(ruct�on Tha( I am au(Iron: ed by �he owner ol this piopei�ty to perlorm fhe <br />wak lo� �vhich applicafion rs matle and I comply wrth (he State Confractors Law iD 27 RCW and <br />296 7.00 LNAC <br />)enniferBurgess , , ,,,,, , .„� �������� 01/17/2013 <br />Signaturc ate <br />