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To: Page 3 of 3 2015-04-23 10:53:59 PDT 12063683197 From: Service_ <br /> • • <br /> 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.everettw..a.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 4919 EVERGREEN WAY, EVERETT, WA 98203 <br /> PROJECT ADDRESS <br /> QFC #852 4919 EVERGREEN WAY EVERETT 9.8203 <br /> Owner Mail Address City State/Zip. Phone <br /> QFC SAME Everett. WA9.8203 <br /> Tenant Mail Address City. State/Zip Phone <br /> Cochran, Inc P.O. Box 335.24 Seattle WA 98133 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> COCHRI*088JS / 19558 (EVERETT) WA 98133 206-368-3201 <br /> State License Number Contract.Price..of Work <br /> COMMERCIAL BUILDING OLEG 206-556-9479 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> ALTER 4 120VOLT 20 AMP CIRCUITS. WO# 19004 <br /> Description of Work to Be Done: <br /> CONTACT: OLEG NADYKTO 206-556-9479 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,.MC OR AC CABLE. 5-1: 1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE..IS 3105 r <br /> I hereby certify that I have read and examined this application and know the:same to be true and j 151.04---11.55go <br /> correct. All provisions of laws and ordinancesgoverning this type of work will be completed { 1 <br /> whether specified herein or not. The granting ofa permit does notresume to-give authority to <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 n <br /> work for which applicatioi..is •made and�1 comply.with the State..Contractors Law 18.,27 RCW and00 <br /> 29.6,290 WAC <br /> > -�®� <br /> i. Signature.i" ,; Date <br />