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O1/23/2006 08:51 4253778977 BGSCH ELErTFIC INC PaGE 02/03 <br /> I _ ��3—�''� <br /> r <br /> � <br /> � ELECTRICAL PERMI� /�P�l.ICATION <br /> CITY OF EVERETT P�RR71T SER.VICES <br /> 3200 CEDAR STREET, EVERETT, V'/A 9820'1 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> I�ZI S��\jFrz�rTMAL�. �Ry(� <br /> PROJECT ADDRESS <br /> QV_SV1K �LT 131?- E t.�IKES'tiOPE 1YL I.RkE SiEUCh1S Wk "13'L`i'+�2�� _'�-���ZI <br /> Owner Mail Address Gry StateIDP Pn«�e <br /> Tenenl MaliPddress Ciry smie2lp �� <br /> r�oScN �t,Ear�ic. ��lC. �v Bcx ro3� �kY S;��'� w��Sz�4 �-zS�K� .�7�S` <br /> ElocUical Contrador MaA address Ciry State2�p ��° <br /> ��=�9��� Conlrect Pnce of Work <br /> 3Ute License Number <br /> g�� Contact Person (Plan Revlew) <br /> Proposed Use of 6uilding <br /> Deacriplion of Work t0 0e DOne' l�`Q� �� CCTrRC�E I�C �� - <br /> NOTE: WIR�NG IN NON-0WELLINGS IS�EQUIRED TO � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 35`` <br /> ClTY OF EVERETT LOCAL SALES 7NC CODE IS 3105 <br /> I horeby cerU�y tha�1 have reed and exnmined thls appUcetlon antl know the same to be true and <br /> correcL Af(provis(ons oflaws and crrlinanc0.s govr.min this fype op(worh will ba compfeted <br /> v�te ecor cacel�ha p�rovlslons ofan�othe�r steto or!�I�aw mguls�g constn9rcUcn oht�ry t� <br /> peAomwnce o1 consizcUon. THaf I arn authonzed by the oKmer ol thfsr�mpe�ry fo peAorm tho <br /> work for�rhich appllcafbn Is mede nnd 1 cromply wlt�the Sfefe Confrac ors Law 18.27 RCW and <br /> i zs6.200 WAC. <br /> ��i <br /> ,, �-�3-c�b _, <br /> S alure � � Dete <br /> \_i <br /> L C(oC� •IU� <br />