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De�, 1), 2015 8:14AM
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<br />EL�CTR�CAL P��.�IT APPL�CAT�ON
<br />CITY OF EVERETT P�RMIT SERVICES
<br />3200 CEDAR STREET, EVERETT, WA 98201
<br />425-257�8810 - FAX 425-257-5857 — www.everettwa.orc�
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<br />PROJECT ADDRESS
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<br />State I_ic,ollsc� Number (requlred) Clty of Everetf �3usif�nss License Nu�er (required)
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<br />p Bi�ildll�g Gnnfract Price of Work
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<br />Sq�tare Footago (If residerttial new cotlsiruction, remodnl nr addition) Corztact Person/Contact Numbcr/Email
<br />NumE)er Of deVEr,es (If Eow voifage)
<br />Description of Work to Be Done: _<�{. „ l, tr"� �w �"�.,f�v�l '"
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<br />CITY QF �V�f2ETT LOCAL SAI.�S TAX CODE IS 3106
<br />! hon�by r.crtify Fh,at ! tr�ve read and exa�rrinor! fhis applicatior, �nd krrow lhe sa�rie fo he truo and
<br />correcL AII ploVlsiw7s of /�ws �nd ordinartc`es �oVe��)in� thls fype of w�rlc wil! be completed
<br />whstl7o� spr.r,itied herein ur' �lo(. The g���ntin� of a peimit does not presurne to c�ive �7ufhority to
<br />violste or' car�cei f1)e p�t�vlSinr�s of any othei'slale or loC��/ (aw re�lfl��tiny r.onstrucFran or lile
<br />peifor���ancn of cnnstrucfio�l. Thaf I anr autl�orized hy the owner uf liiis ��ro�erfy to paform thc
<br />worlc for which a��plrcafion is macic snd 1 cvm�ly wi(I7 the Sfafe Conh:�r.tors Law 18.2% RCW �I)d
<br />296.7.,�0 WAC'�r
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<br />Sf�nat«re
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