Laserfiche WebLink
APPLICATION P'OR �L�CTRICAL P�RMIT <br /> CITP OF EVL•RETT <br /> BUILDING DIVISION <br /> 3200 CEDAR STREET <br /> EVERETI', WA 98201 <br /> 259-8810 <br /> iY(1�T ` -�r, �1�L_ ��r��„ '� f552 36 <br /> 1;,,:�'Li � � C:. ..J l.� i-r,�yl/�l �Ii Wniv �� t��Lqil �1 j'I.r-J <br /> Owner Maii Address <br /> City . Slate/Zip Phone <br /> � , �I��il2d� ��� � / �. { <br /> '� ��% �i� t r� rt�ll `� 9��� I [s� ��Z ' <br /> ieuaot Ma�l Address CitY Stale/Z� � � <br /> i ` / /. ---�— <br /> P Phone <br />' _6LccKeti 7 ��.� IJ'ic l�n �nx `l��l�. f- nl1rL< � ll ��5� �L � r�l%� l�/�l��ukQ <br /> �'Iu.ncal Gbntractor i ' � <br /> � Ma�l Address �Cily State/Zip Phone <br /> I T� � State Li;ec�se No. <br /> ���;n� �t .� <br /> Conlrect Pnce of Work �� n � <br /> 1 Proposed Use of Building <br /> fS//� A� h� ,l; }��, <br /> Pro�ect Address U <br /> r�ril_C� �� � q � / ' � r <br /> Description of Work to Be Done: / n �l,Y�iN) � — d � �{ p � <br /> � � ll1 t P �t1 r�(1't�� � .✓ �� ( I�J �+/ i <br /> � <br /> NOTE:IVAC 296-46-140 REQUIRES THAT PLANS FOR ELEGTItICAL WORK AT EDUCATIONAL, INSTITUTJONAL OR <br /> HEAL'['H CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH IOBS <br /> MUST SHOW THE STATE APpROVED PLANS BEFORE CTTY OF EVERET PERMIT WILL IIE ISSULD. <br /> NOTE:WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND A(', ARE CP_I3LES, <br /> NOT RACEWAYS). <br /> I HEREBY CERTIFY THAT I HAVE RLAD AND LXAT4INED THIS APPLiCATION A1�'D KNOW THL SAME TO BE TRUE <br /> AND CORRECI', pLL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF �40RK WILL DE � <br /> CODIPLLTL-D 1�I1'H WHETHER SPECIFIED HERL-IN OR NOT. THE GItANTTNG OF A PERMIT' DOES NOT PRESUM& <br /> TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PRUVISIONS OF ANY OTHLR STATE OR LOCAL LAW <br /> OWN RAO THISOPROPE TY TO PE FORM HE ORKCFOR WHICH A PL CATION IS MADF AND IOCOMPLY V�TTH <br /> THE STATE CONTRpCTORS LAW 18.27 RCW AND 29G.200 WAC. <br /> � l ' <br /> X . /}i C / •� •� ;� .� - <br /> i <br /> Signature // �� � � Pec //���- U���, ��, <br /> (/ Dalc i <br /> ����:� 1 � �/r� �� �/ <br /> �i«�rr C�isio�� <br />