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AIL4-,0 �/��2 5 <br /> 201 <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1321 Colby Ave. Everett, WA 98201 <br /> PROJECT ADDRESS <br /> Providence 1321 Colby Ave. Everett WA 98201 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Pacific Communications Cabling 10604 E. Riverside Dr. Bothell WA 98011 425-483-5957 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> PACIFCC910L5 f �' � 3454.00 <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of work to Be Done: Voice and Data Only '"Please note on permit: #27194** <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. OD <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby certify that 1 have read and examined this application and know the same to be true and ' I \ <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a 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 <br /> work for which application is made and I comply with the State Contractors Law 18-27 RCW and <br /> 296.200 WAC. <br /> �}� 1 11/25/15 <br /> —-- �nalire`�'.--- --------Date— <br />