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��I�(��`�I�II�T.�i�, d����il�'11 ,��''�� ����I�"N.�%)���! <br />{�'� i 4rP �� �l���s� � �' i��a��8� ����%��.'•�� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />✓ <br />�2� q�D� <br />C � � 12�0�7 <br />f�PPLICATIONS ARE ACCEPTED FROP/l S ANi TO 4 PM - DEBIT �: CREDIT CARDS ARE NOT A�:CEPTED <br />$�l0 � G/a E�cra14 WA 982tl$ <br />PROJECT AD� ESS <br />Owner <br />Tenanl <br />�nnodai��� GI<cl���c. <br />Electrica' Conlraotor <br />� OVEIUSSkr- <br />State Licenso Number <br />S�� SioP <br />Proposed Usa of Building <br />71U'C� Nar(,i� <br />Mail Address <br />Mall Address <br />Mail Address <br />Cily <br />Cily <br />Sfafe/Zip <br />Slate/Zip <br />4903 E <br />SlalolLp <br />12, 5�6. = <br />ConUact Price of VVork <br />ue�+�� G�ia, <br />Contact Person (Plan Reviee�) <br />Phone <br />Phoao <br />Phonc <br />DescriptionofWarktoBoDono: �n5�a��q��° o� auS IZa���Q ��^4��Si�' S�44co�+� T�%(k _ <br />lattc�s.r ��4,� SQW�ce.. � �l b�akch C�rcu� 4s — <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />8E IN RACEWAYS, MC OR AC CABLG. <br />CITY OF EVERETT LOCAI_ SALES TA:: CODE IS 3105 <br />1 hereby certify Ih3� 1 have read and examined Ihis application and know the same to be lruo and <br />correcL All provisions o(laws and ordinances �oveming fbis rype of work �vil! be ccmpleted <br />whether specilied herein or not. The granting ola pormd does not presume to nive aufnonty ta <br />violate or cancel the provrsions of any ofher state or local law regWating construcfion or fhe <br />pc-rformance o(construchon. That I am authonzed by the ov.mer ol this propery to peAorm 1he <br />v✓ork (or �vhich app/icstion is made and I comply with the Slafe Contrac(ors Law 78.27 RCW and <br />7_9G.200 WAC. <br />�.i�v�u/ __�1� <br />/L-9-o� <br />SlgnaWrc Dale <br />FFE <br />.'�_ �i2' (.CDG� <br />