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APPLICATIG��d FOR ELECTRICAL F�RMIT <br />;IttCF <br />evQre#t <br />BUILDING DEPARThIENT <br />?59-BB10 <br />�' <br />.Aeo i �' � 2G itFR�� �?D EVFCE"'T 96'z03 %A.JrIFI/o0 <br />ne��t Ma(Txddresa ty ���one � <br />A ' <br />enant a a rass ty p one <br />N <br />z� `� o E C <br />ro ect tl0ress I \ <br />•..n /l'i v A� A-.n,r�n. . r.� 7N� C.TS]PJ /.Z, BGOQ.O»MS � 9_ RoiH l <br />• � , � ' 1 1 ♦ , I <br />� . I 1 � � i �i/ ' � l . , <br />NOTE: XAC 296-46-140 REO�IflES TIUT PUNS FON ELECTRIGL NORK �T EDUCATION�L� INSTITUTION�L OR HE�LTH GPE F�CILITIES <br />BE MPPOVED 9Y THE STATE OF XASHINGTON. APPLICANTS MITH SUpI JOBS MUST SHOM THE STATE MPHOYED PUNS BEFORE A <br />CIiY OF EVEPETT PEPNIT MILL BE ISSUED. <br />IIOTE: XIRING IN NON-DMELLINCS IS REOUIflEU TO BE IN NETAL RACEMRYS. <br />I NEREBY CERTIFY TMRT 1 HAVE READ AND E%AMINE� THIS <br />APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OROINANCES GOVEflNING TNIS 7YPE OF <br />WOpK WIIL BE COMPLETEU WITH WHETHEfl SPECIFIED HEflEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AIJTHOHITY TO VIOLATE OH CANCEL TME PflOVI510NS OF ANY <br />OTHER STATE Ofl IOCAL UW REGUUTING CONSTflUCTION OR THE <br />PEHFOflMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY iHE <br />OWNEfl OF THIS PROPEflTY TO PERFORM THE WOflK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPIV WITH THE STATE <br />CONTRACTORS UW 1B27 FlCW AND 198.200 WAC. <br />x �, _ 0-7-0�^.Cic� <br />Signa re � Date <br />FEE L_� � <br />