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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 />..-,c I � <br />��l <br />26a�9-W. Casino Rd. <br />PROJECT ADDRESS <br />LBA Realty Fund III Co. IX LLC PO Box 847 <br />Owner Mail Address <br />Majestic Glove <br />Tenant <br />Kirby Electric Inc. <br />Electrical Contractor <br />KIRBYE1077BN <br />State License Number <br />Commercial <br />Proposed Use of Building <br />6707 Henderson Rd <br />Mail Address <br />4826 B St. NW Suite 101 <br />Mail Address <br />Description of Work to Be Done: Temporary power <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Carlsbad <br />City <br />Everett <br />City <br />Auburn <br />City <br />CA/92018 <br />State/Zip <br />WA/98203 <br />State/Zip <br />WA/98001 <br />State/Zip <br />$500 <br />Contract Price of Work <br />Phone <br />Phone <br />253-859-2000 <br />Phone <br />Doug Kirby <br />Contact Person (Plan Review) <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governm� this type of work will be completed <br />whether spec�fied herein or not. The granting of a perm�t does not presume to give authonty to <br />violate or cancel the provisions of any other state or local law regulating construct�on or the <br />performance of.:rtionstrucfion. That 1 am auth i by the owner of this property to perform the <br />work for whicil aqplicat�on is made anc. �1 co ply ith the State Contractors Law 8.27 RCW and <br />296.200 WA`C. �� / / / � <br />i <br />� <br />a' <br />0 <br />FEE <br />5 ��� �; � <br />�- \'� r \ <br />I � �% � �' ��J <br />