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To: Page 5 of 5 2015-11-10 10:19:02 PST 12063683197 From: Service _ <br />� <br />ELECTRICAL �PERMIT APPLiCATION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982Q1 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />12906 19th Ave SE <br />PROJECT AD�RESS <br />FRED MEYER # 458 12906 19TH AVE SE EVERETT 98208 <br />Owner Mail Address City State/Zip <br />KROG E R SAM E Everett WA98208 <br />Tenan# <br />Cochran, I nc <br />Mait Address Ciry <br />P.O. Box 33524 Seattle <br />Electncal Contractor Mail Address CitY <br />� <br />COCHRI*088JS / 19558 (EVERETT} <br />State License Number <br />COMMERCIAL BUILDING <br />Proposed Use of Building <br />Phone <br />State/Zip Phone <br />WA 98133 <br />StateTZip Phone <br />WA--�8-�-�-3--�f =��f�€3-�1 <br />Contract Price of Wark <br />B I LL 206-518-4331 <br />Contact Person (Plan Review) <br />2 NEW 120V 20 AMP FEEDERS TO TWO NUT GRINDER. WO# 22573 <br />Description of Work to Be Done: <br />CONTACT: BILL OGDEN 206-518-4331 <br />NOTE: WIRING IN NON-DWELL{NGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />500.00 <br />CITY QF EVERETT L�CAL SALES TAX CODE fS 3105 ,� <br />I hereby certify tiiat I have read and examined this application and know the same fo be true and (�' �' �� �� f� <br />correcf A!l provisions oflaws and ardinances gaverning Yhis type of work wil! be compieted <br />whether speafied herern or not. The granting of a permit does not presume to give authority to �� ,,.�'��, <br />vioJaie or cancel the provisions of any otl�er state or locat law regulating canstruction or the � !�(,j <br />performance uf construction. That 1 am authorized b}� the owner of thrs property to perform tl�e <br />work for which application is made and ! comply with tf�e State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� .�. .�,.. , � _ , . . . 11110/15 <br />:E <br />Il`]IUfC (�at[: <br />