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_ {' + - <br /> � -- �; , -� _°, =�� � '_� �� ' '' i <br /> �`,��_,I�;�i��I�If`��I�rr�,L, �"' ���II� (i �,� � �,���� � ��b@� <br /> ,���"'� �F ��d�6v�6� I���9�H�' ��E��II��� �,� pl—a�f <br /> 3200 GEDA.rc Sl'REET, EVERETI', WA 98201 <br /> 425-257-881 ] - FAX 425-257-8857—www.everettwa.org i � 2 z� fI� <br /> ;'�PPLICATIOI�S ARE ACCEPTCD FRO;dI 8 P,NI TO 4 PM - DEBIT&CREDIT CAP.DS ARE NQT ACCEPTED <br /> jvo�.., ��cr rc<v� (r+a Evcral{- U!@ 9Q?-o3 <br /> FROJECT ADDRESS <br /> �m u�,��a T�s�� 71�U Na��l�cor R� F�<nc.ft WA 9S�d� `tzs•3Nv71oo <br /> Ownei �— Mall Address Cily StatelZip Fhone <br /> Tenant Mall Address City SlatelZip Phone <br /> �nnodai�vc FI<c��+�c.,Lc PO C{ox �O7N3 ��nwo c� Wh 48036 'izS•2Qo•7Ya3 <br /> Electrical ConUactor Mail Address City Stale/Zlp Phone <br /> 1NR»vF�nsskr IR 7p3 �- <br /> State License Number Contract Price of Work <br /> us s�ap ue�+�n ���a; <br /> Proposea Use of Building Contact Person (Plan Revietv) <br /> DescriptlonofWorktoBoDone: �nt{vIlqE�n o� aus �Q� Q ��'"��'"� � 5�q�`°'� 7GA` <br /> U_���_�`Psf� S V07�ce.. � bra�ch C�rCu�45 <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. / <br /> �/, �S <br /> CITY OF EVERETT LOCAL SALES TA;:CODE IS 3105 <br /> I hereby cerfi(y fhat 1 have read and examined this applicatron ana know the same to be true and <br /> correct. All provisions of laws and ord�nances goveming this fype of wodc will he completed <br /> a�hetherspecified herein or noL The granting of a permd does nof presume to c�ive authority to <br /> violate or cancel the provisions o(any other state or local law regulafing consWction or fhe <br /> per(ormance ol construction. That 1 am authorized by the owner of this propeRy to perform fhe <br /> work for which application is made and 1 comply with tlte State Contracbrs Law i8.27 RCW and <br /> zgr,p00 WFl C. <br /> Siynalure Date <br /> l�0/" <br />