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1 <br /> � <br /> p ��0�� �LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEFtMIT SERVICES <br /> MAY 1 1 2006 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> .. ...................................... APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> CI� F EVERETT <br /> Fn ineerin�l u ic ervi <br /> `P�Zn .4 E'uE�IG/f�'�fFu <br /> PROJECT ADDP.ESS <br /> rz�� .�,�1 o A �. �F„ .—�,��—o�,y�—�.� uk �za3 y�r�-yi� <br /> Owner Mail A dress t Clty StatefZip Phone <br /> e��. ,a� yq� � F,� � �u �U�, �,�r �/�- q�Zo3 ��_ur_ y,og <br /> Tenant Mail Adtlress City Stale/Zip Phone <br /> 360 -�?3-9$ia <br /> B�v����i� i � F�n�iH� ZZo� Ln(.�P S'l' �f�(��rl,�..yl�)(} q�'Z2{ <br /> EleCtfiCa!ConlfaCtof�DMail A dress Ci�y Sla�e/Zip Phone <br /> 8��l97fP►I ol� � NS �8�bo ,00 <br /> State License Number Contract Price of Work <br /> Jn,�I � r.te,— <br /> Propos�Building Contact PQ e� rson Plan Review) <br /> Description of Work lo Be Done: � .�� �(/N f��p» �� /)�S��3L <br /> � �'^ � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �35� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify fhat I have read and examined this application and know the same to be lrue and <br /> conecf. All provisions o//aws and ordinances goveming this type oI work will be comp/eted <br /> whefher spealied herein ornoL The granting ol a permd does notp rnsume to give authonry to <br /> violafe or cancel(he provisions oI any other state or local law regula6ng construction or the <br /> perlormance of conshuction. That 1 am aufhorized by fhe owner o/Mis property ro pedorm fhe <br /> work lor which applicafion is made and I compry wi(h the State Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> S�5�06 <br /> Signalure Da�e <br /> .������ S� ,� <br />