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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 10103 EVERGREEN WAY <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> RITE AID 10103 EVERGREEN WAY <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> SEA-TAC ELECTRIC INC. 400 <br /> State License <br /> Vr_fEf MOLNER <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction, remodel or addition) <br /> (1) LIGHTING CONTACTOR. ADDING (4) CIRCUITS <br /> Description ofworkto Be Done: INCLUDE THE REMOVAL RELOCATION AND INSTALLATION OF <br /> MISC. ELECTRICAL SYSTEMS PERTAINING TO THE <br /> C �CAI <br /> /� TIAI(lCr'1 C(`(1DC !"1C 1A/R(ll! <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. --. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that/have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed G <br /> whether specified herein or not. The granting of a permit does not presume to give authority to (�o O <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 1/15/2016 <br /> Signature Date <br />