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APPLICATION FOR �L�C'I'RICAL PERMIT <br />CITY OF EVERLTT <br />BUII.DING DIVISION <br />3200 CEDAR STRLET <br />EVERETT, WA 98201 259•8350 'i <br />��,...Pi�: f"lrn�,�i lr:.,clF'P•.:vci- i,�,4ha7!_I,jj . <br />�F,. <br />�� � , i� (_.`_� ( `f , �, �� �- ,� . <br />r� � �I ' ib. _ • jUl rC, i/ /� tl i��'_' � <br />u.iV �/<� �=.1 J �1�. "S.'./6i, l'���C��i� �LLL. ��Ci•�F� 7� �:.s�" <br />Owner Mail Addrrss City � Stale/Zip P6one <br />i.�l� �I.. •�� (� <br />Teoant <br />.J ci i 1l �_ <br />Electrical Contractor <br />� :, <br />4a��L_l�:t.� ��!'. ����i i+.rL�. �liE�:"li)^�_ <br />Mail Address . City <br />� -�� <br />Contract Pricc of Work <br />=-� Lc' <br />_ <br />Project Address <br />/IL^v<.c. <br />Mail Address <br />� ii' Lc.�; �! <br />City Sle(e/Zip <br />Q-,.,, l:����„�. <br />Proposed Use of Build <br />! �!c;� .a i�. <br />:� . <br />.2., r <br />[�s} , ��1 i .. ' i l�'%-'!� <br />State/Zip Phone <br />Phone Stale License No. <br />i. J ' <br />Description of Work to Be Done: �� � E� J l r+ �' � z ���'` " �1 �' - <br />J <br />iJ,.t � �(:{ / <br />C <br />\. I / .Y'.- Y � i ��' L. L�(^�i ���' .•� <br />_/ , �� / � <br />� � `I � �: <br />I,-�,�. � i.;i'Ir _)- ("/�`11��1��� IG`..� Y�.n; :�_.U•r'/' %�F�.k; Ll/i <br />_ <br />NOTE: �VAC 296-46-140 REQUIRES THAT PLANS FOR L-LECTRICAL WORK AT EDUCATIONAL, INSTIT[]TIONAL OR <br />HEALTH CARE FACILTTIES BE APPROVED BY THE STATE OP WASHINGTON. APPLICANTS WITH SUCH JOBS <br />MUST SHOW THE STATE APPROVL-D PLANS BEFURL CITY OF EVERET PERMIT WILL BE ISSUED. <br />NOTE: �i'IRING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, A1tE CABLES, <br />NOT RACLWAYS). <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AN!) KNOW THE SAME TO BE TRUE <br />AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE <br />COMPLETED WITH WHETHER SPECIFIED HEREIN OR NCT. THE GRANTING OF A PERMIT DOLS NOT PRESUME <br />TO GIVE AUTHORITY TO VIOLA7'E OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br />REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNLR OF THIS PROPERTY TO PERFORM THE VJORK FOR \V'HiCH APPLICATION ]S MADE AND I COMPLY WITH <br />THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 V'AC. <br />X <br />Signalure <br />. <br />/. ; <br />'''`�-- - <br />�' � <br />Datn <br />F� .�S <br />�t«arc nisis» <br />