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osioai2ois zo ao <br />:zs2s P 002/002 <br />ELECTF�I.CAL R.ERII�IT �APPL.ICATIQN <br />CITY OF EV�RETT, P�RMIT:S�RVI�ES <br />3200 CEDAR STREET� EVER�Tf; �NA 98201` (o .. s� �3 <br />425-257-881D - FAX425•257-8957�—wv,�w.ev6rattwa.org <br />E� 3a 6 --a��� <br />�Z- IC G ,(/0��9A�/ �_ � - <br />PROJECT ADDR�SS ' ` <br />Owner <br />Tennnt <br />`S � <br />Mail Addms6 <br />Aqail Addross <br />� <br />��ry . <br />CIH <br />State2ip Phone <br />:�stoto/Zip �'', :- . Pnono. <br />.G � �1s3 a=�a i �z'), � <br />Elec �cal Cofttraclor hlail Atlnross Cdy: stpto2ip ' Phono <br />�/�,Uy-Siy`�� ,�Od'' <br />Stota.Licanse Number �optract Ptice of.Work <br />� <br />�C: ,: . <br />Proposad Use of BUllding �Co�JAct R.e�son (Piat1 ReViow) , <br />• �. . <br />,; . . <br />squaro Pootago (If resi4antial new co�stPuctlon, remadel ot nddition) .: - <br />, <br />/' . ' ' <br />Number o( �ovicas (I( low wltago) , '� <br />pescription cf �hbfk to Ro Dono: ��°/'l(+ h�� O"''?_,j 7`�����q �� : <br />i <br />� : e�e : � _�� <br />CITY OF EYER�'(T LOCAL SALES TAX C9D� IS 31p5 ;; . r �,�.. <br />1 hereby c3rtiry that I havo rood and oxamined lhis application pnd knqw tho•sam� to Ao tn.�e :and <br />corroct. A/l prov/s(nns otlaws and oNinances govoming this fypn.ol ryetkWill pa wmplu[aU�`'.:. . <br />whetherspeciliod horoin arnot Tha gri�nt/np of a pormit doas nnt presulne 1a give 4ulhonty,lo RERM1Tif . - ' <br />vlolato orcancol f/m pwvrsions otany othdrslnfo oNocallq�y �gulnt/ng conslr.uction or dio : p� /� <br />perfom�ancov(Gonstfuctlop. Th0�4&q7aUfhop:vdbytf�e:o+t�Q@r�f.this-proRyRy,�/op€1f471ttho ; �, E=�I��J� .� .V �S <br />work for whlch qpppcation is made anq ! complY �rith tho Stnto :Cnptfacfora Law :18.27 KCV�.and - <br />296.200 WAG - <br />y,��Gi y��s%9�. . �'V� /�� ��%�. . . � . . -� �.. - <br />� SIf�Odtllt0.. . - .. ' � . � . -. OAIO ,•.�; ._ . .. <br />�r��cco ✓ai� <br />� _ <br />.. , . :. , ... . _:, . <br />1 , : ----- <br />;. <br />i <br />