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_ . , _.; <br /> I� <br /> ___.. .._ , <br /> APPLICATIC''tl'{ FOR ELECTRICAL ���M�T '� <br /> I <br /> , <br /> ��� �vere#�t I <br /> C�H .UILDING DEPAFT�IENT �i <br /> a �n _.9-a810 �j ' <br /> � �� U�� <br /> � �� � _ ..—. <br /> �..nv Ha� �adrees --�y P hone � <br /> � "� (� � �N � 3003 c.��si c�e�Nc�������� ��a q���� <br /> �d Tenern(t e E res� ty p hone � <br /> ��g (30�i N Cs 3 oz�3 �,J�ST �d S I �`L� �� �a��� �.J�4 SQ 0.R2U 3 <br /> c�eecr G ont�actar Ma dareas � <br /> y � RiUt�i Sc+�uct�AV�i r�4�u3aR�.. F� �ox �ui�T� �.� qx��t�T <br /> r y `anenat r ce o�Mar roposetl se a u� a n9 �4 <br /> yH �'Q�r•.�l/f�Sf� 1.34C� <br /> g � <br /> (� tyV1 ro ect rase , <br /> � �°� �lN 30�3 .�� C�SINU �Q� �tJ�R�ir WA al'20'� <br /> yy �nOc on a itarx o e one: _ ! � <br /> O PRo � � l �' �� <br /> So�e.�l a r �E-�� � <br /> �_ _ �i <br /> � - _� <br /> HOTE: NAC I96-46-140 REOUIRES iNAT PlANS FOR ELECTRICAI MORK AT E�UG110NA1� INSTITUTIOIUI OR HEAITH CAAE F/CIUilES I <br /> '� .� BE APPROVED BY THE STATE OF MASHINGTON. APPLIfANTS MITH SUCN JOBS NUST. SHON THE STATE MPROVEU PUNS BEFORE A <br /> � I CIiY OF EVENETT PERMIT WILL BE ISSUEU. I <br /> IIOTE: 711RING IN NON-DNELLINCS IS REOUIHE� TO 0E IN METAL MCEHAYS. � <br /> � / I <br /> � �� <br /> 1 HEREAV CERIIFY THAT I HAVE FEAD ANO E%AMINEU THIS i <br /> ' APPLICA710N AND KNOW THE SAME TO BE TRUE AN�CORflECL ALL i <br /> I! WOpKSWILL BEFCOMPIETED WIO?IH WHETHERVSPECNFIED NE E N OH I <br /> NOT.THE Of1ANTINa OF A PEFMIT OOES NOT PRESUME TO�IYE � <br /> AUTHORITY TO VIOLATE OR CANCEI THE PFiOVISIONS OF ANY <br /> � I I OTHER STATE OF LOCAL UW f1EGUUTING CONSTPUCTION OR 1HE ! <br /> ' PERfORMANCE OF CONSTRUCTION.THAT I AM AUTHOFRED BY iHE � � O � �� , <br /> APPLICATIONISSRMADE ANDPERCOMPLY WI�HKTHE SiATE FEE O � <br /> � �' CONTRACTOflS LAW 18.27 fiCW ANU 296.200 WAC. . .. <br /> �� o <br /> . � <br /> X � � i- �'1� <br /> Slgne'ure Date <br /> �n. a i �3 ��ly� ��ti�?� ��-�_ . <br /> �( ���a- G�-�3`,� <br /> �o �a- - � <br />