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� �5 <br /> a � <br /> �' r..:..., <br /> ��� APPLICATivN FOR ELECTRICAL � ERMIT <br /> N <br /> Z <br /> :m or <br /> � �geverett <br /> Q„ n BUILDIMG DEPAFTMENT <br /> � � 259-�810 <br /> yH <br /> ry <br /> HH � <br /> gN <br /> �..� �' �i5'�r,� ,-�i (� ? Q;�'7G' <br /> �� C� �' �3��r=2 �f;3i1 ��i�y'c,ik- � ,v ; � u � <br /> � 'Ra drees Tty p hone <br /> wner <br /> H N S�+n-L one <br /> O� a d ress �Y �P <br /> �nt <br /> -�/�-l+�-L-' one cens� <br /> ectr ca ontractor ai ress �Y P /� L {7 <br /> C� � �' �/N 0�4Z'�L�l �/�'�✓JJI �Sle�� rGryt <br /> i � <br /> ontract r ce o or ropose se o� � d 9 <br /> .3 ���4'c'C:/t`L / �i' �'! " <br /> r�o)ect dC�ss J _ <br /> </�' ! � -E`� / �ly��'� <br /> iscnpt on o 'Nork a e one: <br /> ���11 <br /> I <br /> � <br /> � '. t10TE: BECAPPRUVED�BY THE STATETOFTMASH'IIGTON.ELAPPLICANT9 WITHTSUCHCJOBSNNUSTISFiONTTHE STATEflAPPROVEDCPUNSAOEFOREEA <br /> ,I CITY OF EVERETT PERMIT WILL DE ISSUED. <br /> ��I 1lGTE: 'dIRII1C IN HON-OwELUtlGS IS REOUIRED TO BE IH METFL RACEWAYS. <br /> � <br /> �. �1� I HEHEBY CERTIFY THAT I HAVE REAG AND EXAMINED T I <br /> APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> PpOV1510NS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> NOT. THELGRANiI�NG OF AO ERIAIT DOES NOT Pf7lE5UDh E TO GIVE <br /> � � AUTHORITY i0 VIOLATE OR CANCEL THE PtiOVI510NS OF ANY J <br /> �� OTHER STATE OR LOCAL lAW FEGULATING CONSTRUCTION OFi THE � <br /> �' PERFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BV THE r����� <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE - <br /> �1� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAGTOFIS LAW 1827 RCW AND 296.200 WAC. <br /> � // <br /> X ,/�'�`�''�:�l�. /- � •`j-�-- <br /> Signeture Date <br /> �! � c"' `r <br /> � � ,_) i( <br />