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t <br /> ELECTRICAL. �ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—vwvw.evereriwa.org <br /> f\PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 6003 23rd Drive West <br /> PROJECT ADDRESS <br /> "I'OC Management S�rvices 68S SW Sandbur�;Strcet "Pigard OR 97� <br /> OWnef Mail Address City S�ate2ip Phone <br /> SupportMed <br /> TeOant Mail Address City SlatelZip Phone <br /> Pmferrcd lileclric 9226 232nd Stree[SW Gdmonds W� 980?0 206.d99.6691 <br /> EleCtrical Conlrador Mail Address City Stale2ip Phone <br /> PI:IiI�Bfi19�PL 5 25,450.U0 <br /> State License Nurnber Contract Pnce oi Work <br /> Ofl itt Spacc <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to ee Done: Sub-I3rcaker, I'ceder,'fransfonnrr, Panel, Lighting, Power& Devices <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. S 526.75 <br /> CIiY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �� / , �, <br /> I hereby certily�hat I have read and examined this applicalion and know the same to 6e true and r��' � l%� —� I I � <br /> co�ect. All prav�sions o(/aws and ordinances govenung h is type ol work wiB be cornpleted <br /> whether specdied herein or noL The granfing of a penrot does not presume to give authonty to <br /> vio/a(e or cancel the provisions o/any other sfate or local law regu/ating construction or the <br /> pedormance ol nstruchoa That 1 am authonzed by the owner o/this property ro pedomr the <br /> work/or which ication is made and I compty with(he Stale Confractors Law 18.27 RCW and <br /> 296200 WAC. <br /> g,29 9 <br /> Si Dale <br />