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( ( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 ��-�`-'�Z <br /> 425-257-8810 - FAX 425257-8857—www.evereriwa.org �1Z0�_ fO� <br /> _� <br /> APPLICA710N3 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 916 Pacific Ave-7lh Floor Midwifcry <br /> PROJECTADDRESS <br /> PRMC 170(173thStrect Gvcrctt WA, 98201 <br /> ONmer Mail Address C�Y 5��� p� <br /> Samc <br /> Tenent Mail Address Ciry StsIdZ�W ��e <br /> Prcfcrrcd lilectric Uox 77120 Scatdc WA,98177 206.499.6691 <br /> EIeG1riCalContfector MailAddiess City StetelLp P�� <br /> PRIiFE131929PL 51,000.00 <br /> State Lioense Number Contrad Price ot Work <br /> Clinic Je(f Olun-20G.d99.G691 <br /> Pmposed Use of Buildirg CoMed Peraw� (Plan Review) <br /> Desaiptbn ot Wak to Be Done: ��'�vuplex Receptacle and Data Ring&Sfring.Receptacle to be extended from nearest <br /> Nonnal Power Receptacle.Receptacle and I IGMC to be Oush mounted and fished accordingly. <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO �E <br /> BE IN RACEWAYS,MC OR AC CABLE. `'��5� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby certily Maf 1 have reed aM exemined fhis epplkefion and know the seme ro be true and �( � (�Z � I U 1 <br /> correct All provisbns o/laws aM ordinances goNeming fhis A�e ol work wiN 6e cornplefed <br /> whether spocified herein or rrot. The granfing ol a pemxf does not presume fo give eutM1aity to <br /> violate or cancel fhe rovisions of any ofliei sfate or local lew regulafing consfn�clion w tfre <br /> ���w�h'�h� �l s mrnade e�1�pl y�byfhe Sf rere� tM1is Law 18.2�7�C W a� <br /> 296.200 WAC. � <br /> �� Date L I� C <br /> �� <br />