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�'I.ECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evcrettwa.org <br />APPLIC� TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1902 120th PL SE suite 201 <br />PROJECTAODRESS <br />11CIRlFCi6lATlt"JS�STEld51NG 11730PLAZAAFAERICADR. RESTON, <br />Owtier Mail AuJress C�N <br />Advanced Medical SAh1E AS SITE _ <br />Tenant Matl Addres3 ��V <br />ADT 11824NORTHCREEKPKWYN BOTHELL, <br />ElcctnC31 Contractor Mail Address ��b <br />ADTSES103205 <br />SLile License I lumber <br />commercial <br />Proposed Use of �uilAing <br />Destrq uan of Wotk lo f3e nonc <br />VA 20190 <br />Statel'_io <br />SinteJZip <br />WA 98011 <br />State2ip <br />Phone <br />703-707-6684 <br />Phon� <br />206-774-949P <br />Phme <br />$5000 <br />Contracl Pnce of WorF. <br />jenn ifer@nwpermit.com <br />Contact Person (Plan Review) <br />Instaliation uf a Lew Voltage Access Control system located in Suite 201 <br />IJOTG WIRING IN IdON-D1h'ELLI�IGS IS P.EOUIRED TO <br />eE ir� �acEwnvs, ��n� or. nc cne�E. <br />FEE <br />(-� �1 �"�, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I he�e6�� ce�irl�� thaf I have reatl and e�ammed th�s applrcabon antl hnow the same fo be tiue and � I`�1 "— ('L! -` <br />carec( Allprovisions o/laws and adrnances �Jovein�ng this !�pe ol wah will be completetl � <br />�vnetnPi specnred nere�n w not Tne grantmg ol a permR tices not presume to g��e autharty to <br />vrofa�e o� canca� the nrovrsrons o/ ariy o�hei stare or loca� �a�v �egulahng constructron w �he <br />perlormanre u1 consD uctron 7na� I am authar:ed h}� the ou�ne� ol rnis propeig� �o perlorm the <br />wah fo� e�nrr.n appncarn_,n is rnade and I compl�' wRh fhe State Contracto�s Lmv lE 2i RCW entl <br />296 2UJ 11'AL <br />Jennifer Burgess ., „ ,„ �" " 02/08/2012 <br />--S�nna•u�e iate <br />