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CITY OF EVERETT <br />BUR.DiNO DIVISION <br />3200 CEDAR STREET <br />EVEREIT, WA 9A201 <br />L. <br />Elatriwl <br />AF'PLICATION TOR EL�CTRICAL PGRMIT <br />., . <br />M�iI A <br />�iiUc� <br />M�il Addreu <br />��� <br />Y58-B8f0 <br />� �',C�t�� -CGt'��i CcA iJ-�3 �� —>�y� <br />City � SutdZip P600e <br />Ci�y SIaldZip P600e <br />44a�- ��.����ck �'�� <br />Cr c.%- i l_uA�`<rk 3z�=�c.��a— <br />City SWe/7ip � Phone S�IelJcenwNo. I <br />Contncl Prim of Wo�ic Prvpoaed Ute of Buildin` <br />ProjstAddrep / <br />Dncriplioo ot Work lo Be Done: �y�y� �� ' n� � ! 7/ <br />Z /"3q I N <br />C�- ���Ii�F-' <br />NOTE: WAC 296�6-I40 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATfONAL, INSTRl1170NAL OR <br />HEALTH CARE FACILITIES BE APPROVED HY THE STATE OF WASHINGTON. APPUCAMS WITI{ SUCH lOBS <br />MVST SHOW THE STATE MPROVED PLANS BEFOR& CR"f OF EVEREI' PERMIT WIU. BE ISSUED. <br />NOi'E: WIRTNO IN NON•DWELLINOS IS REQUIRED TO BE IN MEI'ALLIC RACEWAYS (MC AND AC, AAE CABLES, <br />NOT MCEWAYS). <br />1 N6REBY CHRTIFY THAT 1 HAVE READ AND EXAMINCD THIS APPLICATION AND KNOW THE SAMB TO BE 7RUE <br />AND CORREC(. ALL PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIS TYPE OF WORK WILL BE <br />COMPLETED WITFI WHEfHER SPECIFIED HEREIN OR NOT. THE GRANTINO OP A PERMR DOES N9T PRESUME <br />TO GIV6 AUTHORfI'Y TO VIOLATE OR CANCEL TH6 PROVISIONS OF ANY OTHER STAT6 OR LOCAL LAW <br />REOULATINO CONSTRUC170N OR THE PGRFORMANCE OF CONSTRUC170N. THAT I AM AUTHORIZHD BY THE <br />OWNER OF THIS PROPERTY TO PeRFORM TH6 WORK FOR WHICH APPLICATION IS MADE ANp 1 COMPLY WITN <br />THE STAT6 CONTRACfORS LAW 18.27 RCW AND 296.100 WAC. <br />si¢n.wm <br />% <br />�—'��-r <br />� .4 %IR,rY.,.— <br />- ��-� Fx %�� r —[ <br />D�le <br />�_a�32�� <br />��•=•rr n�sn» <br />