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12/08f2015 17:26 4254897996 HO�v1E RUN ELECTRIC PAGE 02l02 <br />• • <br />ELECT�ICAL PERMIT AI'PLICATION <br />CITY OF EVER�T7 PERMIT SERVICES <br />3200 CE�AR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E} everetteps@everettwa.gov � vwvw.everettwa.gov/permits <br />AGREEMEN7;' Thereby carfify (ha! I heve read 2ntl ex8m/ned this appliCBtlon end �ow the saiite t0 be true end cOrreCt. AIf provisiorts of 1&w5 9nd �dinences gov6rn/ng thls <br />tyA9 01 work wi!! be Canpleted whether 3pBCrBsr/ herern or nol, The qr�nting of a permit tloee not presume to g�Ve aufhorlty to violsta ur car:ce! llte provlsro�s olany orher slete or <br />lqr,91 t�w reguletin9 consbucf3on or the perFO/�nance of consfructiori, 7ha! � am authaizetl Dy the owner of this property to perforrtl ti7e work for which applicaflon !s mede and 1 <br />coi+lply with the Stai9 ContractOfs Law 4�.27 RCW antl 296.200 WAC. <br />Own�rlAuthorized Agent Si�nature <br />Date <br />Cit of Everett Offic�a/ Use On/y <br />FEE <br />.����.;.`� <br />P�RMkT # <br />� I � 12 - t�-t � <br />(Rovrsed 90/17/,2015J <br />