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10/05!2016 13:16 <br />� <br />� <br />#1055 P.001,1001 <br />ELEC�"I��CAL P���r'T APPLICA`X'�O[!I <br />C�7Y OF EVER�TT PERMI7 S�RVICES <br />3200 CEDAR STR��7, �VERETT, WA 90201 <br />(P) 425-25i-889p f�'AX �€25-257-8867 �(�) everetteps c�,,Deveretiwa.gov � www.everettwa.gov/permits <br />�..������� w�. � ��v� Avy �o, �„r ��«� � ��wvo �auu unu cixr�r��rnro m�s appucsr�on ana «now tne same to ba �re and corract, AU provlslons of laws and ordinances goVeming 1hls <br />(ype of wark wilf be campleted whatherspec�ed herein ornot 7he grant/nq ot a permit does not p�sume to g��e authorl� to vlolata orcanco/ tho provis;ons of any other state or <br />/oaa//aw regula6ne const�ucffon o� tho perfonnance of canstructian. That 1 am authorizetl Dy Phe ownor of this proper(y to perfnRn the work for whlch appllcation is made and � <br />comply witA tho State Contractors Law 98.27 RCN/and29B,Q00 WA� <br />�o% <br />A�ent Signature <br />Rata <br />C1ty uf �verett Officral Use Only <br />�S ��� <br />i1�1s-VIN � � _ <br />� �_ - -- --� -v <br />P�RMI1' � <br />E IC�cO-�lS <br />(Revised 90/12�095) <br />