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� � <br /> APPLICATION FOR ELECTRICAL PERMIT <br /> CITY OF EVERETT <br /> BLTII..DING DIVISION <br /> 37A0 CEDAR STREET <br /> EVERETT,WA 98201 <br /> 259-88i0 <br /> ;-��Ue.�GP�., i�/�m.��r, ,,, ,G'�v �12�/ �un fl1'�c7 �f �(�� /"�3b 67L -JS-v <br /> �� 7 Address City State/Zip Phone <br /> w`�l - L-LCL1�.-( `:r rY1 /l�/l2 7rz,w.�o/��iv.i cG��N LL'�F�n ��Lfl � <br /> Tmant Mail Address . ry Stste/Zip Phone <br /> i <br /> �j�p�gy��s1 /��.�or :Q,%[is�l �tC ��� � �(n r u/121 �� J.e'aU/i /��� fsVEla�(A1^�LlU I 1�7 <br /> Elect cal Coatractor Mail Addrcss City r Stay lZip P6one State Liceuse No. <br /> ��� � L�L� <br /> Contnct Prica of Work Pro s Use of Building <br /> l�� Z �U2,� Y <br /> Project Address <br /> Description of Work to Be Done: �$�R.�� � �/�B�f,�� T S�•z.� . <br /> NOTE:WAC 296-46-140 REQUIRES TTiAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTTTITITONAL OR <br /> HEALTH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WiTH SUCH JOBS <br /> MUST SHOW THE STATE ARPROVED PLANS BEFORE CITY OF EVERET PER1vI1T WII,L BE ISSUED. <br /> NOTE:WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I FiEREBY CER'I�Y THAT I HAVE READ AND EXAMINED THIS APPLTCATION AND KNOW THE SAME TO BE TRUE <br /> AND CORRECf, ALL PROVISIONS OF LAWS AND ORDINANCES GOVEIWING THIS TYPE OF WORK WII.I, BE <br /> COMPT ETED W1TH WF�TI-IER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT AOES NOT P12FSUME <br /> TO GIVE AUTHOkITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OT'dER STAT& OR LOCAL LAW <br /> RECULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY W1TH <br /> TI-IE SfATE CONTRAGTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X � <br /> �!°��� ' <br /> �� �%Z � ^--- �z�- r�3 F��- <br /> ` Signature Date <br /> eleaepp(7/S/97) <br />