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� CTRICAL PERMIT �PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />I60� N /3��4�iwAv ±� �i-3 <br />PHOJECT ADDRESS <br />�/'o�i�t..r �Vc i� MGv� 4L Ge1ie� �32 I Cu/5 fiu. �c.<.F,� <br />Owner Mail Atldress City Stete/Zip Phone <br />j�rovicli�«. ��tq I�l, cArL Ivol N /3ro5.��1 Ev.-J-� GA <br />Tenant <br />EleClfiCel <br />[ rr vco 3sL <br />Slate Licen Number <br />cl r✓�c <br />Proposed Use ol Building <br />Meil Addrass <br />Yv� <br />Mail Address <br />C <br />City <br />Stete2lp <br />Stele2lp <br />$ �0c' �� <br />Contract Price of Work <br />S�CvL l�Lo.i.. �. <br />Contect Person (Plen Re ' w) <br />Descriptlon of W ork to Be Done: �.v SJ9 « i I) :i�, � � S�� � <br />Phone <br />7�! -88 S5 <br />Phone <br />NOTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br />EDUCAT ONAL FACILBITIES AND ALL H�EALTH (,'ARE FACILITI SI PLANS WSLL BE RE' EWED BY THIS OF I ETHER <br />NOTE: WIRING IN NON•DWELLINGS IS REOUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />OFT 5I NCHESSABOVE T ECF OOR. WAC 5120 SEC 3 106(�2 TES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br />ENVIRONMENTAL AND OTHER CONTROL FiECEPTACLFS AND OTHER OPERABLE EDUIPMENT WITHIN <br />RANGES OF WAC 5E 20 SEC.�3N 6(b)4CE 8 FI AND NOUT LESS THAN 36LINCHES ABOVOEUTHE �LOOR IN THE REACH <br />I HEFEBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT ALL <br />PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS TYPE OF WORH WILL BE COMPLETED WHETHER SPECIFIED NEFEIN OR <br />NOT, THE GFANTING OF A PERM1IIT DOES NOT PAESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATIIJG CONS7RUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHOFIZED BY THE <br />C�ONTRACOTORSLAW�B27FC1YAND2 6200LNAC.E W�RK FOR WHICH APPUCATION IS MADE AND 1 COMPLY WITH THE STATE <br />s.o <br />'� '" oota <br />Signeture <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />FEE <br />� �'3 /a - vS� <br />