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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 CED�R STR�ET, �VER�TT,WR��201 <br /> (P)426-257-8�10 � FA�425-257-�957 � (�)�v�r�tt�p����t�r�thrr�,gov( www.ev�r�ttw�.gov/p�rmit� <br /> PROJECT SITE INFORNrAT10N <br /> PROJECT ADDRESS: 811 SE Everett Mall Wa <br /> BUfLDING AREA If re�id�nti�l,new constructlon, r�mod�l,�r�dditlon)2600 SF <br /> BUILDINO TYPE: �SFR-DETACHED ❑SFR-ATTACHED 0 DUPLE� 0 MULTf-F�MII.Y-�OF UNITS; 0 COMMERCfAL <br /> U8E OF BUfLDINO: Retail <br /> EL RICAL AP LICATION INFORMATI4N <br /> CONTRACT PRICE OF WORK: $ (QD _ <br /> NUMBER OF DEVICES if low volta e : � <br /> FIRE ALARM? ❑YES � <br /> ABSOCIATED BUILDING PERMIT# if a Ilcable ; <br /> DESCRIPTION OF WORK; Install ei ht CCTV cameras and 10 Intrusion devices <br /> CONTACT INFORMATION <br /> OWNER NAME:RMD Develo 111811t TENANT NAME If Commercial :S rint <br /> OWNER MAILING ADDRE33: BTREET 6219 252nd PI NE <br /> �„� Redmond STATE WA Z,P 98073 <br /> OWNER PHONE: 4258686334 OWNER EMAIL: <br /> CONTRACTOR NAME: TelData S stems Inc <br /> CONTRACTOR ADDRESS: gTREET 1158 Industry Drive <br /> CITY TUkWIIa 8TATE Y�A ziP 9813 <br /> CONTRACTOR PHONE: 206 682 8721 CONTRACTOR EMAIL: srahier@teldatainc.00111 <br /> CONTRACTOR LIC.#REQUIRED: TELDAS955PB CITY OF EVERETT BUSINESS LIC.#REQUIRED: O� l 2 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2066828721 <br /> St@V8 Rc'aI11GP CONTACT EMAIL:srahier teldatainc.com <br /> AGREEMENTr!hsreby certlfy that 1 have read and exemined thls appllcatlon and know the same to be true and correct. Ali provlslons of laws and ord/nances governing thk rype <br /> of work wJll be completed whether specifled hereln or not. The granting of a permlt does not presume fo glve authodty to violete or cancei the provls/ons of any other stete or <br /> local!aw regulating constructlon or the perlormance of constructlon. That!am authorized by the owner of thls properry to perform the work for whlch appllcatlon is made and 1 <br /> comply wfth the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> Clty of Everett Offlclal Use Only <br /> PERMIT# <br /> 1/12/17 E � _ �� <br /> Owner/Authorized Agent Sig ture Date (Revlsed 9/23/2016J <br />