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�;� ,I���`�I�R�.�I�—. �=��I���"9` .���6�'i��►I��:�,��; iic�:;��;�i <br />•,� ��r �� 0�11��F A � s���fi(�A� ��Ftl/1��� CD�/D1—O� <br />3200 CEDAR STREET, EVERETT, WA 98201 ���.��q <br />425-257-8810 - FAX 425-257-8857 — www.evereltava.org � <br />F�PPLICATIOIdS ARE ACCEP7ED FRO��i 8 ANi TO 4 PM - DEBIT �. CREDIT CARDS ARE NOT ACCEPTED <br />3�j'Z�( Ruck�r il�enue. Even.il w� 4YZ�1 <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Electrical Conlractor <br />INf�OVElUSSkr- <br />State Licenso Num6er <br />ijus SioP <br />Praposed Use of Building <br />%ICii� µar�i� <br />Mail Address <br />MailAddress <br />P.O. CS o v <br />Mail Address <br />City <br />Ciry <br />. <br />State/Zip <br />State/Zip <br />YYo3 6 �iz5 • ZQ o <br />StatelZip <br />I� 3G o �=- <br />Conlract Price of Work <br />ci«I�� G��a; <br />Cantacl Person (Plan Review) <br />DescriplionofWorktoBoDano: ���<�y��afior ob a4f f`°��4 �+'�"� � $�q`"''C 7G(l <br />u1te�.rbrouwfi 5�1_«-F � br+Hcti C�r���45 <br />NOTE WIRING IN NON-DWELLINGS IS REQUIREDTO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA;: CODE IS 3105 <br />I l,n,rehy ceriify that I hare read ard examined Ihis application and kno�v the same to be frue and <br />cor�ecL .411 p!ovisions o(laws and ordinances govcming this type ol work �vill be completed <br />�vhelher specdied herein or not. The g�anting oI a permd Aoes nof Presume to give �utha^ty i� <br />violafe or cerr.:el t"^ �rovisiens e! an}� ether state er Iecel!a�srog���tqiy construchon or the <br />periormanco o� r.ons�rucfion. Thaf 1 am aufhonzed by the owner of this property to pedorm !he <br />work Por which applir,afion is rn�de and I cornpl}� wilh Ihe Slafe Confractors Latv i B.27 RC W and <br />29G.200 WAC. <br />SignaWrc <br />i___--__ _ —_ _—_.____ .___.—_---. _ <br />FEE <br />3r�. �/b <br />9� <br />Phona <br />Phono <br />Phone <br />