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APPLICI TION FOR ELECTRIC�` � PERMIT <br /> CITYOFEVERETT <br /> BUILD/NG DlV/S/ON <br /> 3200 CEOAR STREET � <br /> EVERETT, WA 9B20! <br /> (426J 157-8810 <br /> x � i2s ca�6Y ���� Ev�R�7T w,� . <br /> �-�S as� J�� <br /> PROJECT ADDRES8 � <br /> ,�tUF��t7 Al�IAI�c�. cN�R�N ���5 ccc..m� �Fus EU�R,��r w,�- 9'8�� Phona <br /> Owner Mail Addras City Stale2ip <br /> Tenent Mail Addrcas Ciry SfaMJZip Ph�e <br /> � QWNElL <br /> IedricelContrector AAellAddresa Ciry Steta2ip P��e <br /> . <br /> � <br /> � <br /> State License Number Contract Price of Work <br /> Cfl U(�c N <br /> Proposed Use of Building Contact Person (Plan Revlew) <br /> DescripUon of Work to Be Done: � li� � � M !� C' I � U � �_ <br /> I <br /> NOTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE I <br /> APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br /> EDUCAT ONA FACILBITIES AND ALL HEA TH CARE FACIL TIES PLANS WILL BE REV EWED BY THIS OFF CE.ER <br /> NOTE: WIRING IN NON-DWELLINGS 1� REQUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br /> OF 1b NCH S A60VE THE FLOORA WAC 1 20 SECg3106(c)2 ES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br /> ENVIRONMf��� '.L AND OTHER CONTR�L RECEPTACLES AND OTHER OPERABLE EQUIPMENT WITHIN <br /> RANGES�OF WAC 5E 20 SECLON�G�b�4 E S P AND NOT LESS THAN 36 N HES ABO�E THE FLVOOHRN THE REACH <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISfONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WlLL BE COMPLETED WHETHER SPECIFlED HEREIN OR NOT, <br /> THE GR4NTING OF A PERMIT DOES NOT PRESUME TO Gll'E AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE <br /> OR LOCAL CAW REGULATING CONSTRUCTION OR iHE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPEFTY TO Pc'RFORM THE WORK FOR WHICN APPLICATION IS MADE AND 1 COMPLY WITH THE STATF_CONTRACTORS LA W 18.27 <br /> RCW AND 296.2D0 WAC. <br /> I <br /> / G�'— 8.-�t� FEE �� — <br /> Sfgnature Date <br /> 0.EWlxEVlW) �-q-GZZ <br />