Laserfiche WebLink
:� <br /> A'E'1'LICATION rOXt I;L�C'Z'I�CA.I, �'I;RII'xIT <br /> � ,��� or FVHRr:�t-r <br /> 1;L1ILD1NCs L�IVISION <br /> ?200 CEDAK ST'REET <br /> [VL[tLTT,WA 96201 259-8810 <br /> (� `� �� ," DiSwr� I�oLA�, <br /> �i7> ��,nF I I ZIG� /'r9C.1�G �"�1,c.17 �-��..C�7`T �'t �/fi20�/ �ti��'4�.. <br /> Oµrcr t�iail Address City State/Zip Y6one <br /> 1'coant � � � � Mail Addrtss . City Stwle/Zip • � Phone <br /> (' dn'L� \ �--• ��r� 17S`'' l�iit�t � r--r-rt7I11- �/i r�� 1.f�E5 /���:2/YSZ'3��_k� <br /> �Icetrical C:untractor Mail Address Cily SGttelZip Phoae StakUceaseNo. <br /> �,.�SO � <br /> Conlracl Price of Work I'foposed Use of$uilding <br /> 117J1� �� ' t{(.�7`� <br /> PfO�ECL AddfESS ' <br /> Y scription of Wurk to }3c Done:��� �c'CGf2(T�/ S y T�'1 <br /> l <br /> 1 <br /> E <br /> '" _ ,.,,.._�: <br /> NOTE:�VAC 29(-4G•140�REQUIRES THAT P1.ANS T'OR ELECI'R1CAL WORK AT BDUCATIONAL, INSTITUTIONAL OR <br /> IiJ:N;fIi CAI� FACILTTIGS BE APPROVED Bl"THE STATE OF WASHINGTOTI. APPLICANTS WI'IH SUCH JORS <br /> MUS'1'SHOW THI:STATH APPROVED PLANS BEfOIt&C1TY OF EVERLT PER1vIIT WILL IIE ISSULD. <br /> J�07'E:W1RfNG IH NON-DWEL-LINGS IS REQUIRED 7'O $E IDI METALLIC RAC&WAYS (MC AND AC, ARh CAIILES, <br /> 1Q01'RACEW AYS). <br /> I HFREBX CGRTIFI'TIIAT I HAVE REAA ANA EXAM[NF.A 7'HIS APPL.TCATTON A,vA KNOW THE SAME'fo BE TRUE <br /> AND COfi1tECf. ALL PROVISIONS oN LAWS AND O1tUINANC�S GOVERNING THIS TYPE OF WORK WILL AF. <br /> CUMFLh"I'ED WITH WHETHER SPEC1f1ED TiEREIN OSt NO'i'. THE GILINTING OF A PERMIT DOLS NOT FILESUMF, <br /> TO G1VE nUTf10RITY TO VIOLATE OR CANCF.I, THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> kFGULATING CONS't'KUCfION OR THE YEFtFORMANCC OF CONSTRUCTION. THAT I AM AU'I'HORIZED BY THE <br /> U\VNEI: Uf THIS YItOPF..RTY TO PERFORM THF.w'ORK FOR WHICH AYPLICATION IS MADE ANU I COMPLY 1YIT1I <br /> TIIG 5TA7'G CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> // , ' <br /> �"., <br /> _____� �.✓� ,'� � � I�� �7 r-�: � d __. <br /> gn turc Dnte <br /> • ��-�(�� <br />