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EL�CTR�CAL P�RM1T APPL.ICATION <br /> GITY aF EVERETT PEFiMIT SERViCES <br /> 3200 GEDAR STREET, �VERETT, WA 98201 <br /> 425-25�-8810 - FAX 425-257-8857^www_everettwa-org <br /> APPI.�CATtONS AR�A,CCEPTED FROM B All�T�4 PM <br /> � ' � � � G�� 1��� � '� <br /> I D� � 1�� �Pi s� �'�r�� r�� �e1 <br /> PROJEC'f ADDRESS <br /> �i�il�l�� 1�l� � � �/ ��'��7� ���' �� 0 <br /> o�,er �i aaa� c��y Q �no�►e <br /> � <br /> TenBRt MaiE Addr�s Gity StabelTp P�►� <br /> ��� �l � � � S� - 1�t/ QL �'D ����'�� <br /> ��cat co�ntrac�r ru�a�:a�s c�y state�+p � <br /> � l � L5 � � <br /> te Llcense Number' Co tract Pn af Work <br /> f `� �j� l <br /> Pro use o��►i contaCt Person c Review) <br /> I�esc:riptian of Wor�c xo�e Dont3; <br /> U �� � � 0 <br /> NOTE: W(R1NG IN NON-DWELLiNGS IS R�QUiRED TO �� <br /> BE IN RAC�INAYS, MC OR AC CABLE. <br /> CITY UF�VERETT LOCAL SALES'iA1X CODE�S 3105 <br /> f hersby cer�fy thet!have read and examined Ft�ls applicanon and knrnrv the seme ta be tr�e and � � <br /> corr�cf ql1 provisior�s of laws a»d ordina»ces gawemr'n�ihrs type of worlc wiil be completed �,�2-v�-- � � � <br /> whe#her speciferl herein or not. The grenfing of e permrt does nof presume to glve autt�orlty to <br /> vroiete or cance!the pravisions of any oFher st�te or loca!!�►v regulating corlstructiolr or the <br /> performanGe of constructfon. That J am authorized by the aw»er ot tY,is property to perform che <br /> wflrk�Or which appllrat�on i m�de and I comply with the Stats Contractors Lew 98.27 RCW and <br /> 2fl6,2 WAC. <br /> �J � l�i <br /> ignature � <br />