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01/12/2008 12:31 4753536934 EVEP,GREEN SECURITY PAGE 02/03 <br /> I <br /> ELECTF:IC.4L P'E,R.Mi i e4PPLIC�t,TIONi <br /> ��ITY OF F_VERETI' F'ERM�T �f_=RVI�ES <br /> 3200 Gi:DAR STREET, EVERETT WA 98201 <br /> 425-257-8810 - FAXfi25-257-bIIS7—vw�n,��.evr�,;;,ya.org <br /> APPLIGATIONS ARE A�C�r'1"e D �;?L!it;ji tiM TCi 4 PM <br /> �i�J� �t(G�2G���J �t1��/ <br /> PROJECT ADDRESS <br /> /�`���.r�lcx �x�t� u�oi- -�vi R� P.�X�Zs �v`T' q�� 3-�zs <br /> Owner MaIIAdE�ess ciry statc2iv anone <br /> Tenant MailAddress City Stafe2ip Phone <br /> �ICYLbR�tJ ,��r, 2iT�1 � �s"3't,�� �10� �V i Q8�3 4�s-3y�-3 <br /> EleCtticalConiraCtor Mailq ress Clry State2ip Phone <br /> �V��1.i i�-�.d�. �S ��2 .G� <br /> S�ate License Numbcr � Contra t Price of Work <br /> I �-L '�f.� �J�(�-� <br /> Pmposed Use of Building Contac Person (Plan Review) <br /> Description of Work to Be Done: �N S( �'i 1�t�1 � LQvI/ V QL.`/ `�� �'�,-�(� <br /> _ �.1 S?��-1 <br /> - � - <br /> NOTE: WIRING IN NON-DVI�LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �O • � <br /> CITY OF EVER6TT LOCAL SALES TAX CODE IS 3105 '— <br /> I huruby cerYily that I have reed and examined this applicallon end know fhe ssme to 6e true and <br /> correcl. All prnvis�ons of/aws and orclinances goveming fhis type o/woik will6e compleled <br /> whether speciTed hrrroin or noL The qmntinr�o/a peimd does notp resume to give euthonty fo <br /> Wolate o�cancs/fhe provisions ofanyother�fate orlocnllawregulating consWctien o�the <br /> peAormnnce of cons(ruc(ion. That I am nuthoKzed by the ownar o/th/s praperty fo psrion;�the <br /> work for which appllcation is made and I comply W(fh(he S(a�e Conlraclors Law 78.27 RCW'antl <br /> 296 200 WAC. <br /> � � J j ! � �r�5' ,�� <br /> S�An ure � - Dat — /`\1�` <br /> I n <br /> ,✓ <br />