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r <br /> APPLICAT�N FOR ELECTRtCAL�RMfT <br /> ' CITV OF <br /> ' evere#t <br /> ; BUILDING DEPARTMENT <br /> � 259•8810 <br /> ' �'�ir/,4,e1 .YL/ ��N►�rq'�rc.�oc�/i�t'�l` <br /> � ar ai dress ity Zip hone <br /> ; Srs u•�-�.r sb�r c��,,� �,� f�t�.�- <br /> T�nen't/- ai d ress ty ip one <br /> i �firn.Mf.0 �S191�/�,ss. SwL..:�4 1'bLf� sGtel7/ fb4�..�t,cYl1q�. <br /> . i ecer ca ontractor a ress ty p one cense s <br /> � ontract r ce o or ropose se•�g <br /> ; S�1 �' Go.h.�E,�ed� - ��� <br /> � ro eet d ress , , � <br /> }' �OrJi�I �/r! Bit�vT d✓t'�e` su� sr�,.� Y'1.���.c.v <br /> o�,acte� o�io-T e on�: , •• / <br /> ' 1?� yJB'1,1G �fi�td2� d'i' l l CG n'(' <br /> : � <br /> i _�il,Lu,�c . 2 o a � ��.Gr� <br /> � <br /> � NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL MORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH G1kE FACILITIES <br /> BE APPROVED BY THE STATE OF MASh11NGTON. APPLICANTS MITH SUCH JOBS MUST SHOM THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOTE: NIRINC IN NON-DWELLINCS IS REpUIREO TO BE IN METAL RACEWAYS. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BF TRUE AND CORRECT.ALL <br /> PROVISIONS Of UWS AN�ORDINANCES GOVERNING THIS NPE 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 OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR iHE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE r � <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE �.�) <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS IAW 18.27 RCW AND 296.200 WAC. <br /> x , 9 <br /> Signature D e <br /> 3511 I <br />