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ELEGTRICAL PER�ViI i APPLI�A'�IO�d <br />CfTY OF EVERETT PE'r2MIT SERVICES <br />3200 C[DAR STRcET, E`�ERETT, �flA 98201 <br />�f?5-257-8810 - FAX 4�5-25--fiP,S"r - vnv,v everettwa or� <br />Ck�1310-oD�( � <br />10�a,1--i3 � <br />s� � 2 i��,i�� /? �,� � UrR is� 7� <br />PROJECT ADDR�SS <br />__� ? 1 � 2 �? i'#t_� v� z u <br />O�::ner IAa�I Adaiess <br />? enant �dad AC��9ss <br />�'ectriCalCo�!rar.!or r.'_dAdtlress <br />Stale ��censc Ni,mbor <br />, Proposed Use of Buddiny <br />� Sq�.i u� I r o(:�qr III,�sr1� �rt i i:•. .��.nUrir_hon. irni..'rl r,i .�r f h�in <br />'�dun�bor nl d� wc��c Jf I� t� �:n�i,3,�� � <br />�2.-3� <br />Gry <br />C'ty <br />Cny <br />rv�� �z ,�.-r 7 �,,� �,az.• i; <br />StatefZip Phone � <br />I <br />State2ip <br />StatelLp <br />Coniraci Pnce of Work <br />Contac; Peryon (Plan Rewew) <br />Phone <br />Phone <br />� C,. ;cnphpn Ot \Nork Io !3r, I�onr (� � / � U l/ � � L �.-` �. 1 �� I � �L_ l.+ � �� 1 1�I ( � � _ � <br />---r <br />---r..:.?.�— Y--`'.'y--i.'"`G"�''I �'��—�-{'�--��-�J� ��R.;�1�.5--- `� i.,��. 1,f_t�'�__�-�-5 J'�, <br />r� <br />- - --------- -� <br />F[E i <br />�iTY OF EVERETT LOCAL SALES TAX CODE IS 3105 �Q - U� ! <br />� 1 heroby cer7d}' lhul 1 Irave mad and r. rarniried fhis opplicahon and know tl�e sanie tn be fnie and �- -- - --- � i <br />conecf All provis�ons o/laws and orrlmanc governiny fhls (ype ol woik will bc completed -- � � �, <br />� r:hcfhr.r sper.i�ed herr,in or r.ot. The gianfc _ ol a pemiil docs not presurnc- fo yrve aulhonty (o PERMII �_ i, <br />�: o�aro or cancel the previsions o(any ofher state or local !mr mgulafing construction or the t,�,- <br />peifom�ance o/consfrucfion. Thaf 1 �m nufhonzed Uy Ihe o�+ner ol fhis property to per(omi fhe E� l�� �' � o I <br />�vork lor �ro�h�ch apphcafron is m�de and I comply rvdh fhe Sfafe Cnntrac(ors Law 78.2? RCW arr;l ______ _______.__. i <br />296.200 4VAC <br />I �/i ,�1 it,�¢-'�1 i`� 31 �/ 7 <br />