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APPLTCATION FOR i;L�CTRICAL PERIVIIT <br /> CITY GF EVEP.ETT <br /> EUII.DING DIVISION • <br /> 3200 CEDAR STREET <br /> EVERETT, WP_98201 <br /> 259-88Y0 <br /> ��1� Cc��LS'('l� lt���o'ti' � �� 64 I�L'ti(uA.�p}}-�A. S.(/��u , (//�•���2ya �� �' - Zoad <br /> Owner Mail Address City State/Zip Phoue <br /> ZAUt=I?,Gt"' — TiI2yT't,��•/1�RtL' l,u}- � �(�i-11E/f� l.�� — %$Z �3 25"2-2 �_�� <br /> Tenant Mail Address City Stale/Zip • Phone <br /> S3o' S �G�'c�n�c_ }�oS�vGo3 5,����x�,( 1tAi5�v� s4,5-)>0�- 13o 's��e--���s�ek- <br /> E(ectrical Contractor Mail Address City State/Zip Phone State License No. <br /> �'� I Oo �� � (�dY,� r� <br /> Conlract Price of Work Proposed Use of Building <br /> Ci I `� �7 s`!.� c�/Il>l? t' ?i(/ 2v}� �/— <br /> Project Address ' , <br /> Descriptien of Work to Be Doae: �j C' � DYi t=^�N /1 I �-�'^ C'� t n T7(a qi d �L I �l o P � <br /> i = <br /> �I��� L': _ 'Dncut2_1 S �ll�>�' "�� ti.. 0 , 1AiS �l4CLt=n 1- c j/�o�`� � �'� ��r 1 S RN- v— <br /> N E �D S t� O C3 E L��'✓.vL-'c�F c' I) � �v(IZ�' R�c,�, u L L�D • _i�I� 1 S i S r�.,v �. fi f=o J2 <br /> �V�C L � <br /> NOTE:WAC 296-46-140 REQUIRES THAT PLANS FOR&LECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR <br /> AEALTH CARE FACII.TTIES BE APPROVEll BY'THE STATE OF WP.SHINGTON. APPLICANTS WITH SUCH JOBS '• <br /> MUST SHOW TF�STATE APPROYED PLANS BEFORE C1TY OF EVERET PERIvIIT WII,L BE ISSUED. <br /> NOTE:WIIZING W NON-DWELLINGS IS REQUIRED TO BG IN METALLIC RACEWAYS (1�4C AND AC, ARE CABLES, <br /> NOT RACEWAYS). —`— <br /> I HEREBY CERTIFY TI3AT I HAVE READ AA�D EXAMINED THIS APPLICATION AND KNOW THE SAME TO B�TRUE <br /> At�?D CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVEFWING THIS TYPE OF WORK WILL BL- <br /> COMPLETED WITH WHfiTHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT YRESUME <br /> TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TAAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOR�f THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH <br /> THE STATE CONT72ACTORS LA1� 18.27 RCW AND 296.200 WAC. <br /> X.� � / <br /> � <br /> . \1CC9�.�� C�KTz•'l„_ �-Z-��-9-� r� ��` SC <br /> Signature . Date <br /> �//oL.,.,Z <br /> elecapP(3/5/9J) <br /> '_" i . <br /> r <br />