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APPLICATIvN FOR ELECTRICAL � cRMIT <br />CITV OF <br />eVQre#� <br />BUIIDING DEPARTMENT <br />259•8810 <br />-6623 <br />JEANNE OLSON 3830 FEDE4AL EVEpETT 98201 ?52-6E2? NM 355-0241 �!K. <br />enant a� d ress ity p hone <br />FviaNnFR�� sAI s s, ����ICE PO EOX 1u79 EVERETT °8206 25�-�lEl EYLAtiS�142LP <br />eeEit7{cal ontractor ai dros�3 s �t ti y — p one cCi ense � <br />antr�act�ice oi WorK oTn4�s�F��-sr��FTding�c�E���E <br />3R3f1 FFiIFRAI .G�u�- <br />ro ect <br />Discription a Work o e Done: <br />60A CI?.CUIT FCR S4�IIMMI�lG PCOL <br />NOTE: WAC 296-46-140 REpUIRES THAT PLANS FOR ELECTRICAL MORK AT EDUCATIONAL� INSTITUiIONAL OR HEALiH CARE FACILITIE$ <br />BE APPROVED BY THE STATE OF WASHINGTON. APPLIGNTS MITH SUCH JOBS MUST SF:OW THE STATE APPROVED PLANS BEFORE A <br />CITY OF EVERETT PERMIT WILL BE ISSUED. <br />NOTE: WIRING IN NON-DWELLINCS IS REpUIRED TO BE IN METAL RACEWAYS. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS 1YPE OF <br />WORK WILL BE COMPLETED WITFi WHETHER SPECIFIED HEflEIN OR <br />NOT. THE G(iANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOFiITY TO ViOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL IAW REC,ULATIN� CONSTRUCT!ON OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFOHM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />GONT ;ACiORS LAW 18.27 R�W AND 296200 WAC. <br />,X Q �o M�ll� ,� (�� � s=4a <br />Signature Date <br />FEE s�5 , nn <br />3�0 3� <br />