Laserfiche WebLink
� , <br /> _u Pr_ic���rro��� roR ri.l:c�rizlc:�1� I�ri:ar� r <br /> V�' <br /> ;> s'a <br /> CITY OF EVERETI' <br /> BUTLDING DIVISION <br /> 3200 CEDAR S7REET <br /> EVEREIT,WA 98201 <br /> 259-8810 <br /> C�«0.!?C ��1� �'�n �t��+'( / , �1��� '�~'ti� v�.t 4 L t L� >J�—� � �,, <br /> �� Mail kddress Ciry StatelZip Phonc <br /> � �SX �_ <br /> � �.�y�� ,��-'� l�_c_„�-�-�- � 'U.'�- ��(4 d / <br /> Tenant Mail Address City StatelZip ' Phonc <br /> /���-'c�'U- l c � �i � /�-�� / � <br /> Electncal Contrector Mail Address City State/Zip Phone State License Nu. <br /> .� C i��P, , C) cJ �p�� f—. - � ! - .�. _ j <br /> »� � � <br /> Contrac Price of Work Proposed�1J�: 'of}3i.�1d(n,• <br /> � C <br /> Project Address <br /> i y � <br /> Description of Work to Be Dona_�W � v'C' ��,C_��cy? C�/% [1 u �-v �,i Q��`7 c=f' <br /> ,/�� (� /� 0 <br /> °' '"'e{-�.,' . \�(�.-� [/ J � '�- <br /> I _ <br /> NOTE:WAC 29G-46•140 RLQIJIRES THAT PLANS FOR ELECTRICAL WORK hT LDUCATIONAL, Ws7:i li7'li�'�*.q1, oH <br /> i HEALTH CAAE• FACILITIL-S BE AI'PROVED BY 'THE STATE OF WASlIINGTON. APPLICANTS wI7�H ',Cic'1 7C!i;� <br /> MUST SHOW THL STAT'L APPROVED PLANS BEFORE CITY OF EVERET PERMIT WILL HE ISSUL-U. <br /> NOTE:WIRiNG IN NON-DWELLINGS ]S REQUIREU TO AE 1N METAI.L]C RACEWAYS (MC AND AC, Ai<I' t'NiI,LS, <br /> NOT RACLWAYS). <br /> I IiLREBY CERTIFY THAT I HAVL- RL-AD AND �XAMTNL�i'fII1S APPLICATTOT` AND KNOW T'Hg SAA4L TO BL• TR1JL <br /> AND CORRECT. ALL PROV1S10�'S OF LAWS H1dL� ORJINANCL-5 GOVERNING THIS TYPE OF WORK Wi1.1_ IiL <br /> COMPLETED WITH �i'3�E•THGR SPL-CiPIE-D HLRL-IN OR NOT. THE GRANTING OF A YERMIT DOES NOT PRFSii'd!. <br /> TO GTVL AUTIiORITY TO VIOLA7'E OR CANCLL THL YROVISIONS OF ANY OTHER STATL OR LGCAL 1_:���' <br /> REGUI.ATING CGNSTRUCTION GR 'I7�E PERFORMANCE UF CONSTRUCTION. THAT I AM AUTHOAJZGD AY 7731[ <br /> OWNE•R OF 'I7iIS PRGPERTY TO PE-RFORM THL WORK FOR WH1CH APPLICATION IS MADE AND 1 COMPL}' WITH <br /> THE STATL- CONTRACTORS LAW 18.27 RCW AND 29G.200 WAC. <br /> X � � ; <br /> i � 'tj �'1 O <br /> % <br /> . .r'L� � r��� ' -! <br /> =�. Pcc-- — <br /> Si�nature p;:i;,� <br /> ��.._����pis�p��� <br />