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ELECTRICAL PERMIT APPLIC��ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—vwdw.everettwa.org 7 ` �f`�Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� .L v.-� _ � 6 5 <br /> 10025 19th Ave SE <br /> PROJECTADDRESS <br /> Lakeside Endodontics, SAME AS SITE EVERETT, WA 98208 <br /> Owner Meil Address Ciry Stale2ip Phone <br /> SAME AS SITE 4253578747 <br /> Tenant MailAddress City Slele2ip Phone <br /> ADT LLC 11824 N CREEK PKWY N, SUITE #105 BOTHELL WA 98011 360-945-2787 <br /> Eleclrical Contractor Meil Address Ciry Stale2ip Phone <br /> ADTLLL*881 DO 649.00 <br /> State License Number Contract Price of WorA <br /> Comrrercial Jennifer Burgess (Agent) <br /> Proposed Use of Building Contact Person (Plan Reviewj <br /> oes���Pc�o� or wo�h�o oe oo��: Instali low voltage sec�arity system with one control and six devices <br /> h10TE' WIRWG fN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ,\ <br /> � ��� <br /> CITY OF EVERETT LUCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have reatl and examir,ed this application and knoo-i the same to be lrue and <br /> correct. All piovis�ons o/laws and ordinances govemmg this type o/work wrll be completed I�(�� � I �j j <br /> �vhetherspecdied herem or r,ot i'he granting o�a p=nmt does notfrresume ro give authodry to <br /> vrolate or cancel tne prov�sions o!any other stata or local law regu ating consh�uction or the <br /> peiformance o/consbuction. That/am aulhorrzed by the owner of ihis property to pzrform the <br /> �vor/: for which application is matle and I compty�vith the State Contractors La�v 18.'7 RCW and <br /> 296200 WAC. <br /> Jennifer Burgess ��'������ � �'�=���� 07/31/2012 <br /> ignaWre ale <br />