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AI'PLICATION rOR ELCCTRICAI, I'IsR111IT <br /> crrY or•E��xerr � <br /> IIUILDING DIVISION <br /> 3200 CFDA.4 STREET <br /> LVERETT,WA 98201 <br /> 259-8Bf0 <br /> G.��sn,s /7i5� 9/�i ��s��.�y ��,%I.t� �uN fiioi �?..s��sYy <br /> Owner Mail Addrrss � City Swte/Zip P6one <br /> Tenenl Mail Addrcss Ciiy Sw�e/?ip phone <br /> /G�'�— <br /> EJjclrical Con�nctor Mail Addrcss City Slale/Zip Phone Slnle Licenu No. <br /> l���d'� , � D <br /> Contract Price o(Work Proposed Uu of Building <br /> ---�'J�L�� <br /> Projut Address / / <br /> Drscriplion of Work to Be Done:�i(/$�/� NL4f� C/�w✓� S �}vl/ l/�9✓1��2f <br /> NOTE•:WAC 296d6-140 REQUiRES TIaAT PLANS FOR 6LtiCIRICAL WORK AT bDUCATlONAL, IN577TUTIONAL OR <br /> HEALTIi CARE FACILIi7GS BE APPROVED BY TfiG STAi'E OF WASHINGTON. APPLICANTS N7TIj SUCH ]065 <br /> MUST SI{OW TIiL STA7L•APPROVGD PLANS DLPOhL•CITY OF GVEREI'PL•RM[T WILI:HE ISSUGD. <br /> NOTL:WIRING ]N NON-DWELLINGS IS RLQUIItGD TO OG IN ML•TALLIC RACGWAYS(M11C AND AC, ARL• CA➢LGS, <br /> NOT RAC6l4'AYS). <br /> 1 IfERL-6Y CEnTTFY TIiAT I HAVE READ AND EXAMINLD THIS APPLICATION AND KNOW THE SAME TO➢E TRUG <br /> AND CORRECT. ALL PAOVISIONS OF LAWS AND ORDINANCLS GOVEIWING THIS TYMi OF WORK N'ILL BE <br /> COMPL[TGD WIT19 WIdLi79GR SPECff1ED NGRLIN OR NOT. TIiG GRANiiNG O' �PERMIT DOliS NOT PRLSUME <br /> TO GIVL AU7]iORITY TO VIOLATL• OR CANCLL TI9L °ROVISIONS UF ANi VTHGR STATE OR LOCAL LAW <br /> RL•GULATING CONSTRUCTION OR THL• PGRPORMANCE OP CONSiRUCf10��. T 1AT 1 AM AU77iORIZED BY TIiE , <br /> OWNGR OF TIiIS PROPLRTY TO PERFORM THG WORK FOR N991CIi APPLICATIO'�IS MADG AND I COMPLY WITI� <br /> 771G STATE COhTRACTORS LAW 1A.27 HCW AND 296.200 WAC. <br /> � �,�.,t��.P �����,,,,._ ,a-,l� y � <br /> r� .�L� <br /> Signeture po�� <br /> ��«•rr nrsro» I <br />`� - - — - ---— <br />