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� _ <br /> APPLICATION FOR ELECTRICAL PERMIT <br /> CITY OF EVERE7'I' <br /> BUR.DING DMSION , <br /> 3200 CEDAR STREET' <br /> EVERE'IT, WA 98201 <br /> 3 I�S co 1 b y. zss-sa�o <br /> EFREM _ AGROn�OFF l�6� EvQtET k�fF y'b�o� <br /> Otwer Mul Addrcss <br /> A �� Ce� C�h' State/Zip Phone <br /> � x F�o•, � ( � s��� �,(6�✓ <br /> �t /j q /' f <br /> � I�C l.[M� �t'I c!N L � SO !I/ Pl p{ SZ G cq I L s/ �U.G( Q <br /> Tenant Miil Address c � {•UJ 7��U/ I <br /> � City State/Z�p � Phone <br /> L\ � � �G �/ = � _ -.z�G I' <br /> Elx 'cal ConlracWr Mai1 Address ��/�NS'S /YZ�P � <br /> Ciry State/Zip Phone State License No. <br /> '�3SZrc� � �� � �--. <br /> Contract Pnce of Work � �' P <br /> Proposed Use of Bu�ldmg <br /> �-� �{ ���O <br /> Projxt Address <br /> Description of Work to Be Done: � �"� �f f ' '/ � <br /> � � � ,,, __t'vi e ]�ece c� �-,cV � <br /> � fv�c c. �^7j� <br /> L 'u <br /> c:_ e , <br /> NOT'E:WAC 296�6-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTTIUTIONAL OR <br /> ��'TH CARE FACII.ITIES BE qPPROVED BY 7'F� STATE OF WASHINGTON. APPLICANTS V1Z'I7i SUCH JOBS <br /> MUST SHOW T[iE gTqT'E qppROVED PLANS BEFORE CITY OF EVEAPT'pgRHiIT WILL BE 1SSLJED. <br /> NOTE:WIItING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLiC RACEWAYS (MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I HEREBY CERTIFY THAT I HAVE READ q►JD EXAMINED TfiIS APPLICATION AND KMpV✓THE SAME TO BE TRUE <br /> AND CORIZECI', pi,i, pROVISIONS OF LAWS AND ORDiNANCES GOVERNING THIS TYpg OF WORK WILL BE <br /> COMPLE'1'ED W('1'H WHETHER SPECIFIED HEREIN OR NOT. THE GRANT[NG OF A pg�yIT DOES NCT PRESUMg <br /> TO GIYE AU17ipR[7'y TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LpW <br /> REGULA77NG CONSTRUCTION OR THE PERFORMANCE OF CONS'I'RUCTION. THAT I AM qUTypgIZED BY THE <br /> OWNER OF Tf�IS PROPERTY TO PERFORM '['HE WORK FOR WHiC?i APPLiCATION IS MADE AND I COT4PLY WITH <br /> 7HE STATE CONTRpC7'ORS LAW 18.27 RCW qND 296.200 WAC. <br /> i� <br /> X ^ <br /> � ����-�� ��ti / - - � -- <br /> i ; Signature � �� � �� Fee . `�� <br /> v Date <br /> ' U���b <br /> elecerP(�/s/9)) <br />