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IaUG 12 ' 93 11 :50 rP.Oh�MNET—SERTTLE 1 �y . <br /> PqGE . 001 <br /> APPT.TCA'�'ION FOR �LEC'�RICAL PERMiT <br /> � � � <br /> 9H <br /> iD � x CTT'Y OF EVERETT <br /> � Hx t�n gTJII,DING DMSION <br /> y y H 3200 GDAR STREET <br /> k � n EVBgfiI'T,'P!A 96201 259-8810 <br /> H :U <br /> �� N /; // <br /> � x � (�Av,bn&x�C'-0• a f/ � �V /.(�' G'�Ci3 a2�7-175/ <br /> R� Cy ���. Mail Addrrss Ciry StatelZip Ptioca <br /> OH <br /> � � g � <br /> y�V C] <br /> Z H� .. � 'IviMil Address City StateJZip Pfiont <br /> y y x Tecan; . . <br /> �1Hy � . . <br /> gdti <br /> � �, ;,.,e�c� /7e�fwoares ry,.�f s S /8G'�'�' S'� k¢nr toA 4QD3Z zsi-os4z�F�lZsnl�t-o7i <br /> � E(ectncal Cont�Rccor irluil Address City State/7a,p Phone State Lieeose No. <br /> z ��i'S,a� Go-,nLrt- <br /> y o� Pro sed Ux of Build'wg <br /> Concract Price af Work p° <br /> �/a2 9 E vcr�� °e..-i (:V�.. �t c ���,rcfi� 95203 � <br /> '•' . � . . .'! project Addre� � <br /> j; , r <br /> 1 � <br /> � y�, Descripticn of Wozlc�Be Done: � , , <br /> �� - � . ,co� vBrn��'�� sys c�,�-��G3� <br /> ' " - s��- i� <br /> , r, ,.�x- ✓ �# i o 8� <br /> I �� . <br /> � � NOTG:WAC 296-4G-140�REQUIRES THAT PLANS FOR ELECTRiCAL WOBK AT EDUCATIONAI., INSTCf[TITONAL OR <br /> , �'y <br /> MtT H THE SfA�TE�ROVkT�PLANS BEFO�S�'f)'uF EYE:tEI'PERMIT�✓if-i-E I�r�p�� SUCFI JOBS <br /> NOTB:WIItWG W NON-DWEL.LII�IGS IS REQUIRED TO BE IN M�i'ALLIC RACfiVVAXS (MC AND AC, ARE CA3LFS, <br /> NOT RACEWAYSj. <br /> ��� <br /> i�Y cERITFY THAT I HAVE READ AN�EXA� D THIS AYPL[r,n";[ON KNORN�SAME TO BE iRLTE <br /> AND RRECP. ALT. PROVISIONS OF LAWS AN�ORbINANCFS GOVEr NWG 5 1' FS o�PR�ESi7MFi <br /> COMI'L R A HEREQi OT. GR G A PE <br /> '�I�, TO GIwE A 01� CANCFl. THE IO OTI-IE �StATE L AL T.A�' <br /> REGULA i . rIE fERFOR�AN O CON T I� A . BY TFIE <br /> OWNER OF THIS PROPERTY TO PERFOFM TiiE�i'ORK FOR R`HICF� N 15 MAD�E MPLY WITH <br /> THE STATE COIVTRACI'ORS LAW 18.27 ItCW�ND 296.200 WAC. <br /> x • � � s-- 1��93 Fu �o.o�a-' <br /> Si ature . bale <br /> cleeapp(d!5 <br />