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� �y <br /> y�� APPLICATION FOR ELECTRICAL FtRMIT <br /> K � <br /> oH 7pa <br /> 'i1 y'+tl <br /> -irv cr <br /> � � evere#t <br /> O �..i 3UILDING DEPARTh1ENT <br /> � �g �S9.eo,o <br /> (�]Y (� <br /> � Hr <br /> �"�y /1 C I hnn. <br /> �y N /7� �— ni ,adr.ss � tv �� <br /> Q M �Tw;'ner / <br /> C��N <br /> y��"j .nant a� tl ress l t-�y� hone <br /> HON � �o � (i . � P.7 �3�r��J /�1�.1�/Tn� `15�J�5 3:;,- .J7// ��ro•, C �:�4i/ <br /> n ettr ca l n[ractor ei ress C�y— ����'one cenee <br /> g.. � � AL %ti /-�55c:",r -� c: ,/;iir <br /> AntraCt ce 0 'No�— —�����Se sc o u� ng <br /> VO' ` j C I <br /> /a c �• ' <br /> ro ect Odress <br /> J�sCr O[tun o '+�ork o e ane: <br /> ! /lP e �,;�) J`1 r � �-7 � Rc lcA�"• s . <br /> / 1 � <br /> '—' _ — <br /> '�1 tIOTE: MAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL XOflK nT EOUCATIONAL� INSTITUTIONAI OR HEALTH CARE FACILIT�ES <br /> BE APPROVEO BY TNE STATE OF WASHINGT@1. APPLIGNTS WITH SUCN JO05 NUST SHON THE STATE APPflOVED PUNS BEFORE A <br /> ' ' CITY OF EVERETT PENNIT WILL AE ISSUED. <br /> � 90TL• WIRING RI NON-OWELLIIIGS IS tiEOUINE� TO flf RI METFL RACEWFYS. <br /> / 1 <br /> '�' <br /> 1 IIEREBV CERTIFV TNAT I HAVE REA� AND E%AMINED THIS <br /> '� APPLICATION AND KNOW THE SAME 10 BE TFlUE AND CORRECT.ALL <br /> � PROVISIONS OF LAWS ANO OROINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE C0IAPLETEO WITH WHETHEF SPECIFIED HEREIN OR <br /> '�I NOT. TNE GRANTINQ OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> ' OTHEH STATE OR LOCAL LAW REGULATINO CONSfRUCTION OR THE <br /> PEHFORMANGE OF CONSTRUCTION. THAT I AM AUTH0�7�2ED BY THF. o <br /> ' �PPLICA�TION'SSRMADE ANDPE COMP yHEWiO�Ki Ep STATE FEE �-+4`�� I�7 � <br /> � CONTHACTORS lAW 1B27 RCW ANO 296.200 WAC. <br /> / '� X <br /> � Signeture �°�" <br /> 3��5 <br />