Laserfiche WebLink
p <br />No: <br />C <br />APPLICATION FOR ELECTRICAL PERMIT <br />aTY CF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />C I <br />F,., 4 <br />> � h�,,,-a 1�,�.._�6••stia {�...p,1�' (70 l 41 s �- s,.rk A-2 <br />p <br />,Ienirnt Mail A8dre5s City Zip Phone <br />JA r41t•c �I<c��•-ia ��9. Jlf'+ ';4-S;w a,yw..M 4$OI(— �7v-66(3 C ' 0o7 1) S <br />ectr ea ntratttlr Ma Aeoress ty // p hone License <br />^� ��[1 e•e . <br />antractrce o - Wort roposetl sea u tl ng <br />•i� � I C�ckeV� �.•evcf�l�)as�l . <br />Project Address <br />Disc ription ofWork To BeDone: <br />1. Cl�, l Li ou W •t T' Itir :�Pl. �(� Cxr's�lc c1 c%v c�;r,� •— c�(�l 2 i__ �Oc't <br />C� Iir11..'rS rG+Clue.-Vr1e1KL- <br />1 p <br />1 r crc4 ef" ��f ��•�)�ch1t'�cc'�D1�c�rS i 1�> <�oc,��r i•,�l�ck V�a-�c�,:14vlc sr <br />kZI <br />T�I/ i- / <br />1 r'ly ru e••1// L•-'evk rck Lt air. .lee..(- TV�-.-l.., t�-rl gvr-CS <br />NOTE: WAC 29-+6-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br />BE APPI,TVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br />CITY Oi Zrc" PERMIT WILL BE ISSUED. <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO BE IN CONDUIT. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />.�. ..�I WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR /f� <br />NOT. THE GRANTING OF A PERMIT GOES NOT PRESUME TO GIVE o/ /IL <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM ALTHORIZED BY THE / <br />' ly OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE <br />\\ APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND 296.200 WAG. <br />OC,tIeI o C�l�c .cif z <br />Signature Date <br />{ <br />