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APPLICAT�N FOR ELECTRICAL rERMIT ��,�y4, � <br /> CITY OF [VfR[f' <br /> OUIIDING �IVIS'ON <br /> ��� 3200 CFTAR ST�EET <br /> C�y EVI'RETT� MA 98201 <br /> q A H 259-88 f 0 <br /> a�cn <br /> y � � Cinrrinn)L �Cy 11l �n�-.s_ /5.9�' % - �/c J�n'.... C� ,j �....�-�:-:_- i6c37 JYJ - l� > : J '. <br /> K n ner —F1ai ddress ity 3tate ip hone I, <br /> y� i <br /> '�tl rx+� � <br /> VJ H � <br /> enan� [ a� d ress ity ta[e p one <br /> � zo� / ) s� � I <br /> OHC7 �Y1"InK {� Y- � / �Jl_ l Yh �D`� � JS-1 )�L �, ��_ ��./✓J �i'J�1t\ � S�")UIl�_ L'f._s : l✓ I <br /> H ��y f�c[��cel'Cd�ractor MaiT'�ess LTty —St� p one 3tate e�nseFTo— � <br /> O <br /> EH3 ��� ./1�a ��i , y. � <br /> �• y z on[� rac[ Fr ce a or ,� roposP etl-Usn at uui d ng II � <br /> � <br /> Ny � ' <br /> gp.� �iJ. � . [..1_� �� � fi .�y .� n .�".l '�, <br /> n �N ro� ject JCddres� �� . <br /> ❑❑❑ � <br /> �C�7� - � <br /> y yy DlscNption of Work To �e Donc: t -�r %�,� � / r� s"1 � i/r L - i7 .S� - ..��i •-^7 !✓h � .=< i <br /> O ! <br /> I nrL/lliii� �c r � c ��• . � A ` 1- � <br /> I <br /> � <br /> i <br /> �^ � <br /> � — � <br /> NOTE; WAC T96-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORN AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> ,r ,� !IE APPROVED BY THE STATE OF WASIiINGTON. APPLICAN�S WITN SUCH JOBS MUST SHOW THE STAfE APPROVED PUNS BEFORE A � <br /> � ' CITY OF EVERETT PERHIT WILL DE ISSUED. , <br /> w <br /> NOTE: WIRING IN NON-�WELLINGS IS REOUIRED TO OE IN CON�UIT. � <br /> ! ""�I I HENEBY CERTIFY THAT 1 HAVE FEAO ANU- EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME 70 BE TFUE AND COfiRECT.ALL <br /> PfiOVISIONS OF UWS AND OR�INANCES GOVERNING TNIS TYPE OF <br /> WOfiK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ' -+ NOT. THE GRANTING OF A PERMIT DOES N0T PPESUME TO GIVE <br /> .�UTHOFITY TO VIOIATE OF CANCEL THE PROVISIONS OF ANY <br /> O7HER STATE OF LOCAL UW REGUUTING CONSTRUCTION OR THE �,��- <br /> - PEFPOfiMANCE Of CONSTRUCTION.THAT I AM AUTHORIZED BV THE �-7, --� <br /> OWNER OF THIS PROPEFN ?O PEAFORM THE WOFK FOF WHICIi FEE � <br /> � APPLICATION IS MADE AN� I COMPLY WITH THE STATE — <br /> t' <br /> CONTRACTORS IAW 18.27 RCW AND 296200 WAC. <br /> � X ' . <br /> ��l '�77" � S/Y7^i•-LL�._ /! // Y / i: � <br /> Signature �a[e <br /> I <br />