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� ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERPlIIT SERVICES <br />I 3200 CEDAR STREET, EVERETT. WA 98201 — <br />i 425-257-8810 - FAX 425-257-8857 <br />L— <br />PROJECT ADDRESS _ , , , � ,, :, y�;_ - <br />Owner <br />Mad Aoeress <br />City <br />Tenant 4'lan Aearess ��' <br />A�'��Icn ► Elech-i� lhc ,��-�y Redl�nwk�Y � <br />Eledripl GOMradar Me�l Mareas . �C <br />��n� acz`i72l�3 Z✓05 <br />State Liaense Number <br />Proposed Use of 6uilding <br />pescription ot VYork lo Be Done: <br />SlatefZip <br />Stale/Zro <br />� 4� �a <br />Contrad Prioe oi Worlc <br />7.�� <br />Ptwne <br />Pnone <br />-435���iz� <br />Ji'Ae �i2�A11'1 �Z`✓ r�z�`l� <br />Contact Penon (Pian Review) <br />NOTE: PIANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITI[S UTILIZING STATE FUNDS MUST BE <br />APPROVED BY THE STATE O� WASHINGTON. APPLICANTS WITH SUCH J08S MUST SHOW THE STAT[ <br />C-DUCATIONAL FACILBITIES AND ALL HEALTH CARE FACILIITIES PLANS WILLEDE REV EWE BY THIS OFFI OE HER <br />NOTE WIRiNG IN NON-DWELLINGS IS REOUIRED TO B[ IN RAC[WAYS, MC OR AC CABLE <br />HANDICAPPED ACCFSSIBIUTY ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />OFT 5� NCHES A OVE THE FLOOR AWAC 5120 SEC 83106(�2TES OF TRAVEL SHALL 8E MOUNTED A MINIMUM <br />ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTNER OPERABLE EQUIPMENT WITHIN <br />RANGES OF WAC 51 20 SEC.O3N 6(b)4CE 8 FI ANDRNOT L SS THANV38LINCHES ABOVE THE�F OORIN TH[ REACH <br />I H[REOY CERTIFY THAT 1 HAVE HEAD ANO U"AMINFD THIS APPLICATION AND KNOW THE SR:.iE TO BL- iRUE ANO CORRECT ALL <br />��EGHANiING OF A PEHMIT�'�DOES N07 PREOSUME'T,O 61VE AU� �OR7T� OKV OI ( A�E OR CANCE �7NE Pl70V S ONS OF ANYEOTHER S A7E <br />OR LOCAL LAW R[GULATING CONSiRUCiION OR TNE PERFORMANCE OF COYSrRUCTION. THAT I AM AUT110HIZEC7 BY hlE OWNER OF <br />THfS PROPER7Y TO PERFORM THE WORK FOR lM-0CH APPLICA710N IS MADE AND 1 COM!'L Y LVITH THE STATE CONTRACTORS U1YY 18 27 <br />RC6V AND 296200 WAC <br />��_z, ;,� Fee <br />/ ,)� �f,� �,-�- "' <br />� Date <br />SlgnaWre <br />f 1 FCFP(REV 8�2001) <br />_ u � 7 '` � �7 <br />i .. <br />