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06/OS/�_014 11: 4`_ 253-631 -7754 PROvIGE��T E�ECTP1`: �AGC 0?/02 <br /> • - -- --- -- • — ---- � � <br /> ELECTRIGAL PEF:MIT APPLICATION <br /> I, CITY Of� EVERETT PERMIT SERVICE.`.i <br /> 3200 CEDnR STREET, EV[RFTi, WA 98201 <br /> 425-257-8d10 - FAX �•25-257-8ff5 7 -ww�v everett�va org <br /> APPLICATIONS ARE ACCEP7ED FROM P AM TJ 4 PM <br /> — - -- — _' _� <br /> �� „�3 ..� O`l� �r .SE � <br /> PROJECT ADDRESS <br /> �mu'�I�ne.�ye�' CI�ZH lVk�tl�_— c.� qBo�2. �2S�z�S�i�liG� <br /> . Owner tilall AA�ress Clty Stale/Z�p ��one <br /> I _____--__ <br /> Tena�t � Ma�i Adh�ess �:^Y <br /> Siale�I�p �'none <br /> �rt�(Ic��G�jL�1C.. fb�xr]�g�l CvJI -- - — C,��la-253-(a'sl1`150 <br /> Ei9cldca'� Contra�lor h1a�l nddress C. Ste�e%I�p FnonC <br /> �pV�Io3C�— __ — - -- <br /> Stale Liconse Numbar ContraCt�'nce o1 Wo�k <br /> ProDosotl Use o1 Bwldmg �� o �n Rev�c� <br /> DescnpGon of WoM to Be Done ���(tiNY 1_�' " � � `�� ��� O --- <br /> —'� <br /> NOTE b'JIRWG IN NON-01NELLWGS IS RFQUIRE[) 10 FEE —�O/� - - I <br /> F3F IN FtAChW�VS, MC OR nC CAHLE <br /> CITV OF EVERETT LOCAL SAL[S TAX CODE IS 7105 <br /> ��1 �{ OC� - Oy� � <br /> I hereb y cerhfy thaf/�ave�ea0 and exam�ned flr�s opphcafion and know Me sema ro he hue and <br /> co�ect All pr�v�s�ons ol laws anJ ord,r:ances govere�ng tbis rype ol work wdl bo complefnA <br /> whefhe�speci(Pd horem a nnf 7ho grenhng of a permrt does nof presume to grve euthonty to <br /> vrNBfc or cancef Iho piovisions ol any ofhor stete o�local law regula�rng conshuc0on or Ihc <br /> pr.r/om�;�n,�e ol cunstrwiron Thaf I em eulhnri:ed by f�e ownor o�lhis property toOp�o�n fhA . <br /> wort�lo�wh�ch aCF���a6on�s mado and I compiy wdh thn Sfa!o��o�!r�cfnrs Law 18 7/RGtNnntl ' <br /> 296 700 INAC <br /> LVuu►�I }.f��. ��- 4I51�� -- - <br /> �-- 5ignalu�e / J -.-�—.. - 17a1e <br /> V <br /> I <br />