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_� � <br /> � <br /> APPLICAT�N FOR ELECTRICAL� 'ERMIT � <br /> ���-.,::,., <br /> CIiV OF <br /> evere#t ' , <br /> ��� 9UILDINGDEPARTMENT <br /> .� 259•8810 <br /> R��x <br /> H <br /> >Hx�fn / � � <br /> � �x H d�1.J C� I7/7 �"�.</I�`� �n,-e�� ��ZU ! .�.Sd�/67 / <br /> K O ner Mai Atldress 6+Cy ip hane <br /> O x0 q Y(� � <br /> � ~� ai dCress � ity ip hone <br /> y�-i enant • <br /> � z� �1�2�'�-5�',i�l ����n� • c�� :,�¢S! �e.a/j c�z.rl / .�-,,i-J,�i"/ �i�E�sSf1'i���w <br /> �,�, d F e�lcaT—Cnntrector ; Ma� dCress 6tty 1p hone lcense # <br /> � �g Nb , ���� �P5l�ticU <br /> �"'� � ontract r�ce ot 'n� " roposeE se ot ui ding <br /> (�]Y n <br /> z H� / �/ ' �'[, v� �7� <br /> 9 �-3 x ro ect EEress <br /> t� <br /> �-+H <br /> gy H iscriptian o ork o e one: <br /> "v� .4'"G� �3 O O „ �-G . <br /> r� r�� , v J�c,L�i <br /> �i <br /> H O!n <br /> i <br /> .�� NOTE: WAC 296-46-740 REOUIRES THAT PLANS FOR ELECTRICAL WORN AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> 6E APPROVED BY THE STATE OF WRSH�NCTON. APPLIGiNTS WITH SUCH JOBS MUST SNOW THE STATE APPROVED PLANS BEFORE A <br /> !; CITY OF EVERETT PERMIT WILL 8E ISSUED. <br /> NOTE: WIIi1NG IN NON-DWEILINGS IS REOUIRED i0 BE IN METAL RACE{YAYS. <br /> '�� <br /> � � <br /> v � I HEREBY CERTIFY THAT I HAVE flEAD AND EXAMINED THIS <br /> I � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND OfiDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE Ofi CANCEL THE PROVISIONS OF ANV' � <br /> '�' ' OTHER STATE OR LOCAL LAW REGULATiNG CONSTRUCTION OR THE I <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE �/ Q d <br /> OWNER OF THIS PROPERTY TO PE-FORM THE WORK FOR WHICH FEE � <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> � I CONTRACTOFiS LAW 18.27 RCW AND 296200 WAC. � <br /> X � G�iLL�✓WV �p� �d7���� _ <br /> ''� Date <br /> Signature <br /> .�,.— � � , �� <br /> L� <br />