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CIfY OF EVERETT <br />B � DAR STRE� <br />E��TT� WA 98201 <br />Teaant <br />�PLICATIOy <br />Addr:ss <br />Mzil Addre,�ss , <br />--•—w��•raqcp� Mail Addrtu —' <br />/9�� <br />Coatract Pnce of Work <br />'' ProJec� <br />Ducriotioa of Work to Be Done: <br />FOR ELECTRIC�, pERI1,u,y <br />City <br />City <br />f �e � <br />City ' State/�„p <br />�Fi� <br />Proposed Use ot Auilding <br />StzWZip <br />SLite/Z�p <br />Phone <br />zss-esro <br />Phoue <br />raU/�c_.�'�1..� <br />NOT'c: WAC 296-�{6- �� „"""s,-'-.- <br />140 REOUgt�g �1T PLANS FOe� tL��C -�' <br />HEAL.Tfi Cq,i� FACII.IIiE3 BE APPROVED BY 'I'FL STATE OF ��RF: AT EDUCAIIONAL� 1NS <br />DSUST SHOW '� STATE qppRpy�D pL�S BEFORE C[i-y OF EVER..�'I' pg�tI.I. � �UTIONAL pp <br />i?INGTON. AppuC�Ts �.1.H SUCH JOBS <br />NOTE; WgZpqG � NON-D1YE[�,p,rGS IS FtE �-L BE ISSUED. <br />NOT RqCgtiy,yys� QUIRED TO BE LY h1ETAL,LIC R10EW <br />AYS (1vIC �D qC ,e� C�LES, <br />�� I`��BY CERTIFY T'HqT I HA <br />.1ND COF�RECT. ALL PRO � READL,IND E�.'1.\(4YED T'-TTS :L'PLIC:ITIOIJ qj.rD KNOW � <br />; COMP(„g�D y�rj.j. H �SIONS OF AMD O R D L y,�,`' C_ <br />' TO GIV$ q � I E R SPECIFIED HEREi.*! OR VOT, ' S G O Vg?.MNG TfijS 'j-ypg �F W� B E T RU� <br />fi UTH�RI71' TO VIOLq'1'E OR CANCEL r�'L G'�'�'��C' CF A PERMIT DOES �"L BE� <br />�G�TMG CONSTRUC�70N OR THE PERFORhi,WCc OF CON TRUOF A� O�ER STATE OR � CqI,SJ�W <br />�' �H'NER OF TIilc PROPERTy TO PERFORH '� WORt FOR `,t'F?ICH ,aPPLICA770N IS MqDE <br />,` ii� SI'ATE CO �ON. TFIAT I,a1vt q(17�O�ZED BY THE <br />MRACI'ORS LAW 18.27 RCW ,�.(D 296.2C0 1VAC. <br />AND I COMPLY WiI'F <br />Date <br />Fee�,_ `�- <br />eleeePp � <br />