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From: Innerspace Electric InFax: I8^o'o) 723-4107 <br />� <br />� <br />To: Fax: +1 (425j 2578�57 Page 3 of 3 O8l05/20164:1^o PM <br />�ECTRICAL PERMIT A�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />Hvncciwe�v �: i nerepy cert�ty tnat � nave read and examined this applrcation and know fhe same fo be true and correct. All provisions of laws and ortirnances governing fhis <br />Eype of work wrll be complefed whether specifred herein o� not. The gianfing of a perm� does nof presume fo give aufhorr�y to violafe or cance! the provisrons of any other sfafe or <br />(ocal law regulatrng construcfron or the performance of consfruction. Thaf I am aufhorized by the owner of this property fo perform fhe work for which applicafron is made and ! <br />comply wdh the Sfate Contractors Law 18.27 RCW and 296.200 WAC. <br />Please call �125-609-8533 for payment. <br />auw:�a��ew��o� n <br />Brian Hels� nm�:��'x,,,,"" <br />�,.� o,�s�pm,, , tm. g/05/2016 <br />Owner/Authorized Agent Signature Date <br />City of Everetf Offlcial Use Only <br />FEE <br />� ��� ��� <br />PERMIT # <br />E(���� �1 <br />(Revised 10/12/2095) <br />