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Owner <br />k��, � <br />Tar.ant <br />ELECTRICAL PER"V(li APPLICATION <br />CITY OF EVERETT PERIV�IT SERVICES <br />3200 C�IJAR STRE�1', EVERE77, WA 88201 <br />425-257-Ei810 - FAX425-257-8857-www.everethva.org <br />APPLICATIONS AFtE ACCEPTEb FR01118 AM T� 4 PM <br />AbDRESS - <br />Mall AtlGtOsc <br />1uOeplii 2�llvk� <br />Ma1l Nidrcss <br />Gry <br />Clty <br />EleclriCal Contractor Mail Address �� Clty <br />��'�4�t'.�.1' /y ��.8' <br />SWte License Number <br />� �Clor�,�t.�',t' <br />Proposed Uso af B ild�ng "'— <br />StatefGp � 1 � phono <br />H <br />��-� �� 513 �f'r(-���' <br />S�«D i Phone <br />""t7""'�L�j��—"—u�= <br />StatefL'p „phono <br />�a �` <br />��/ , <br />ConUact Prlce ot Work <br />Contact Person (Plan Review) <br />Ooscription ol Work to Bo Done: LCQ /Y�vR IY��f� [/ U�� <br />!f <br />NOTE: WIRING IN t40N-DWEL�INGS IS REQUIf2ED TO <br />6[ IN RACEINAYS, MC OR AC CABLE. <br />CI7Y OF EVERE7T LOCA� SALES TAX CO�E IS 3105 <br />f hemAY certily 7hnt 1 hnve mad and exeminod thls appllc <br />whether sp�fod hero n or noL n7he p�mnlfng of a portnif <br />vlolafa or cancef tltep mvlslons ofany oiher sta(o orfocal <br />peKormonco of consUvcflon. That I am nuthoNzod by fhc <br />worlr lor whfGi ap llcotron is made and I comply wlfh (ha <br />296.200 WAC/ � <br />R <br />a <br />end <br />(o bo tnro and <br />�mpfefad <br />aufhorrry to <br />m ortha <br />pedorm thn <br />27 RCW enA <br />�EE <br />/"O m b <br />J <br />E13p �- 2( O <br />� <br />l00/l00 d L31�« 1b�00 EIOZ/BZ/90 <br />