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���+� <br /> j����`01� <br /> ELECTRICAL PERMtT APPLICATI4N ����� <br /> CITY OF EVERETT PERM[T SERVICES <br /> 32Q0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857 —www.everettwa.org <br /> APPL[CATIONS ARE ACCEPTED �ROM$AM 70 4 PM <br /> �3�1 �olby Ave. �v�r�tt, W�9�201 � <br /> RROJ�CT ADDR�S� <br /> Provide��e 1321 �alby Ave. Everett WA 9���� <br /> Qwner Maii Address City StatelZip Phone <br /> Tenant Mait Address Ciry State2ip Phone <br /> Pacific Communications Cabling 10604 �. Riverside Dr. Bothell WA 98011 425-483-5957 <br /> • �leCtfiCa!COntreCtOi Mail Address City StatelZip Phone <br /> PACIFCC9'fOL5 ���6�J ��jj 3 .00 �� � 9 � ' <br /> State License Number Con. act ice of W rk <br /> Proposed Use of Building Contact Persan (Plan Review) <br /> aescript�on of work to ae pone: N�istribution To Patient Raams on 6A& 7A '`*Please nate on permit: #27216** <br /> NOTE: WIRING IN NON-DWELLENGS !S REQUIRED TQ FEE ^ <br /> BE IN RACEWAYS, MC �R AC CABLE. �,—�, `OD <br /> �U ✓ <br /> CITY O� EVERE77 L(�CAL SALES TAX CODE IS 3105 <br /> !hereby certify that t have read and examrned this application and know the same to be true and '' <br /> correct. Al!provisions of laws and ordinances goveming this type of work wil!be compteted �l�l t'"' ` �� <br /> whether specified herein or nof. The granting of a permit does not pr�sume#o give authority to <br /> violate or cance!the pmvisians of any other state arloca!!aw regulating construcfion or the <br /> performance of construction. That!am aufhorrzed by the owner of this property to perform ths <br /> work for which applicatian rs made and!comply with the Stafe Confractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> 11/25/15 <br /> Date <br />